Venetoclax exposure reduced to 7 days vs standard exposure in patients with newly diagnosed AML

For patients with AML who are ineligible for intensive chemotherapy, the standard of care is a combination regimen of an HMA such as azacitidine (AZA), plus venetoclax (VEN).¹ The effects of reduced VEN exposure to a 7-day cycle compared with the on-label 28-day cycle are unknown.¹

A retrospective analysis compared response rates and tolerability of AZA for 7 days plus VEN for 7 days (7 + 7 regimen) from the first cycle (n = 82), vs standard-dose HMA plus VEN (std-HMA/VEN; n = 166), in patients with newly diagnosed AML.¹ Findings from this analysis, including composite complete remission (CRc) rates and OS, were published by Willekens et al. in Blood Cancer Journal.¹

Key learnings

The CRc rate was similar between cohorts (72% in each; p = 0.95). The median number of cycles until best response was two with the 7 + 7 regimen, vs one with std-HMA/VEN (p = 0.03).

The median OS was not significantly different between the cohorts, at 11.2 months (2-year OS, 28%) with the 7 + 7 regimen vs 10.3 months (2-year OS, 34%) with std-HMA/VEN (p = 0.75).

Platelet transfusion requirement during the first treatment cycle was significantly lower with the 7 + 7 regimen vs with std-HMA/VEN (62% vs 77%; p = 0.02); as was 8-week mortality (6% vs 16%; p = 0.03).

Similar response rates and OS were observed with reduced 7-day VEN cycles vs standard VEN exposure. Reduced VEN exposure may offer the potential for improved adherence and mitigation of drug interactions, particularly in older patients receiving multiple treatments.