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Outcomes with varying Ven duration in ND AML: A retrospective, genetic risk-stratified analysis
Results from a retrospective, genetic risk-stratified analysis of outcomes with different venetoclax (Ven) durations during cycle 1 in combination with azacitidine or decitabine in patients with newly diagnosed (ND) acute myeloid leukemia (AML) were published in the American Journal of Hematology by Kumar et al. The study aimed to assess the effects of the different Ven durations on survival and response rates, toxicity outcomes, and prognosis.
Key data: At a median follow-up of 37.7 months, median transplant-censored survival was comparable across Ven durations, at 13.3, 11.9, 16.8, and 13.2 months for 7- (n = 33), 14- (n = 117), 21- (n = 96), and 28-day (n = 294) schedules, respectively (p = 0.65). Median transplant-censored survival for high-, intermediate-, and low-risk groups was 6.3, 11.5, and 18.3 months, respectively, stratified by European LeukemiaNet (ELN) 2024 risk groups (p < 0.01); and 6.9 and 17.8 months and not reached (NR), respectively, by Mayo genetic risk groups (p < 0.01). Among ELN high-risk patients, 14-day Ven was associated with inferior transplant-censored survival vs 21- and 28-day Ven (p < 0.01). Rates of Grade 3 neutropenia (p = 0.23), Grade 3 infections (p = 0.72), or Grade 3 thrombocytopenia (p = 0.98) did not differ across the Ven durations.
Key learning: In this study, transplant-censored survival outcomes in patients with ND AML receiving Ven + hypomethylating agent therapy were primarily driven by ELN 2024 and Mayo genetic risk, rather than Ven duration during cycle 1. Prospective, risk-adapted studies are needed to determine whether Ven dosing can be individualized according to genetic risk.
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