In a nutshell
This study examined If venetoclax (Venclexta) with decitabine (Dacogen) or azacitidine (Vidaza) is effective in treating elderly patients with acute myeloid leukemia (AML).
This study concluded that venetoclax with decitabine or azacitidine could be an effective treatment in these patients.
Some background
Acute myeloid leukemia (AML) is a cancer of the bone marrow and immune system. It is often treated with powerful chemotherapy. In elderly patients, these treatments can cause life-threatening side effects. Less aggressive medications are required in these cases.
Venetoclax works by blocking the action of a protein in the body that helps cancer cells survive. This helps to kill the cancer cells. Azacitidine and decitabine are medications called hypomethylating agents (HMA) which target cancer cells to stop them from dividing.
It is not known if combining venetoclax with an HMA is safe and effective in treating elderly patients with AML.
Methods & findings
145 patients with AML were included in this study. They were 65 years old and above, and had not received treatment for AML previously. They were unable to receive intensive chemotherapy as they were at high risk of experiencing serious complications. They were assigned to 3 groups receiving 3 different doses of venetoclax. Each group also received either azacitidine or decitabine for an average of 8.9 months.
Complete remission (with or without blood counts returning to normal) was seen in 67% of the patients overall. 73% of the group that received low dose venetoclax with an HMA experienced complete remission. This was the combination with the least side effects. Complete remission rates were 60% in patients aged 75 and above. The response to treatment was similar in patients who received azacitidine and decitabine.
The average length of time before cancer returned in these patients was 11 months. The average length of survival after treatment was 18 months.
The most common severe to life-threatening side effects were low white blood cell count with fever (43%), anemia (25%), low platelets (blood cells involved in clotting, 24%), and pneumonia (13%). 74% of patients developed infections.
The bottom line
This study concluded venetoclax combined with an HMA could be an effective treatment in elderly patients with AML.
The fine print
This study was funded by AbbVie, the manufacturer of venetoclax. This study had a short follow-up period. Longer-term studies are needed.
Published By :
Blood
Date :
Oct 25, 2018
