Shorter Duration Induction Venetoclax Feasible for Older, Unfit AML

By Leah Lawrence - Last Updated: September 6, 2023

Use of a shorter duration of venetoclax in combination with hypomethylating agents (HMAs) for older or unfit patients with newly diagnosed acute myeloid leukemia (AML) appeared to be well tolerated with comparable outcomes to a 28-day cycle of the drug.

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Hina Khan, MD, of the McGovern Medical School at the University of Texas Health Science Center in Houston, and colleagues presented the results of a real-world outcomes study of attenuated venetoclax as a poster during the Eleventh Annual Meeting of the Society of Hematologic Oncology.

The currently recommended 28-day course of venetoclax for older or unfit patients with AML “remains a challenge due to prolonged cytopenia”, according to study researchers. This single-center retrospective study looked at outcomes from 18 patients with AML treated with venetoclax plus a HMA at Memorial Hermann-Texas Medical Center.

The HMA regimens used in these patients included decitabine 20 mg/m2 for 10 days (14 patients), decitabine for fivve days (3 patients), and azacitidine 75 mg/m2 for seven days (one patient).

The median duration of venetoclax was seven days, ranging from as short as four days to as long as 14 days. Doses of venetoclax ranged from 100 mg to 400 mg daily.

The composite complete response rate was 61% after one cycle of induction chemotherapy; five patients achieved complete remission and six, complete remission with incomplete hematologic recovery.

No deaths occurred within 30 days of induction and the median overall survival was 12.5 months, outcomes that the researchers said were comparable to the 28-day venetoclax regimen.

“Our data support a shorter duration of venetoclax in combination with HMA,” they wrote in their abstract. “Further studies are required to optimize the duration of venetoclax within the context of this regimen.”

Reference

Khan H, Yohannan B, Cervoni-Curet F, Rios A. Real world data on clinical outcomes of newly diagnosed acute myeloid leukemia (AML) patients treated with hypomethylating agents (HMA) plus shorter duration of venetoclax (VEN) at a general hospital. Abstract AML-046. Presented at the Eleventh Annual Meeting of the Society of Hematologic Oncology. September 6-9, 2023; Houston, Texas.

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