All content on this site is intended for healthcare professionals only. By acknowledging this message and accessing the information on this website you are confirming that you are a Healthcare Professional. If you are a patient or carer, please visit Know AML.

The AML Hub uses cookies on this website. They help us give you the best online experience. By continuing to use our website without changing your cookie settings, you agree to our use of cookies in accordance with our updated Cookie Policy

Introducing

Now you can personalise
your AML Hub experience!

Bookmark content to read later

Select your specific areas of interest

View content recommended for you

Find out more
  TRANSLATE

The AML Hub website uses a third-party service provided by Google that dynamically translates web content. Translations are machine generated, so may not be an exact or complete translation, and the AML Hub cannot guarantee the accuracy of translated content. The AML Hub and its employees will not be liable for any direct, indirect, or consequential damages (even if foreseeable) resulting from use of the Google Translate feature. For further support with Google Translate, visit Google Translate Help.

Steering CommitteeAbout UsNewsletterContact
LOADING
You're logged in! Click here any time to manage your account or log out.
LOADING
You're logged in! Click here any time to manage your account or log out.

The AML Hub is an independent medical education platform, sponsored by Daiichi Sankyo, Jazz Pharmaceuticals, Kura Oncology, Roche and Syndax and has been supported through a grant from Bristol Myers Squibb. The funders are allowed no direct influence on our content. The levels of sponsorship listed are reflective of the amount of funding given. View funders.

2020-03-25T14:49:50.000Z

VIALE-A study of venetoclax plus azacitidine meets dual primary endpoints

Mar 25, 2020
Share:

Bookmark this article

On November 21, 2018, the United States Food & Drug Administration (FDA) granted accelerated approval to venetoclax in combination with azacitidine, decitabine or low-dose cytarabine (LDAC) for patients with newly diagnosed acute myeloid leukemia (AML) ineligible for intensive induction therapy due to older age (≥ 75 years) or coexisting medical conditions. This decision was dependent upon the confirmatory phase III clinical trials, VIALE-A and VIALE-C.1

It has been announced that the VIALE-A trial (NCT02993523), comparing venetoclax plus azacitidine to placebo plus azacitidine, has met the dual primary endpoints, with the combination therapy leading to a significant improvement in overall survival (OS) and composite complete remission rate.2

VIALE-A2,3

  • Phase III, randomized, double-blind, placebo-controlled, multicenter study
  • Patients with previously untreated AML who were ineligible for intensive induction chemotherapy (n = 431) were randomized 2:1 to
    • venetoclax (400 mg, orally, once daily on Days 1–28) + azacitidine (75 mg/m2, subcutaneously [SC] or intravenously [IV], once daily on Days 1–7)
    • placebo (orally, as per venetoclax dosing schedule) + azacitidine (as above)
  • Patients were defined as ineligible for intensive induction chemotherapy due to
    • age 75 years
    • comorbidities that are incompatible with intensive chemotherapy
  • Primary endpoints: OS and composite complete remission rate (complete response [CR] plus CR with incomplete blood count recovery)
  • Secondary endpoints: event-free survival, CR and CR with partial hematologic recovery, transfusion independence, and patient reported outcomes

VIALE-C4

In February 2020, it was announced that the phase III VIALE-C trial (NCT03069352), comparing venetoclax plus LDAC to placebo plus LDAC, failed to meet the primary endpoint of a significant improvement in OS in patients with newly diagnosed AML who are ineligible for intensive induction chemotherapy.

Future directions

The full results from VIALE-A and VIALE-C are expected to be presented at an upcoming medical congress. The FDA has not yet commented about whether the results of the VIALE-A or VIALE-C trial will impact the current approval.1

The AML Hub are currently focusing on an editorial theme of ‘novel combination therapies using targeted agents’. Venetoclax is a targeted agent that inhibits Bcl-2 and is under investigation in various combination therapies, such as with the hypomethylating agents azacitidine and decitabine, as discussed here. To learn more about targeted agent combinations in AML, click here.

Expert Opinion

  1. FDA approves venetoclax in combination for AML in adults. https://www.fda.gov/drugs/fda-approves-venetoclax-combination-aml-adults. Updated Dec 14, 2018. [Accessed Mar 24, 2020]

  2. Roche announces Venclexta/Venclyxto combination improved overall survival in people with previously untreated acute myeloid leukaemia. https://www.roche.com/media/releases/med-cor-2020-03-23.htm. Published Mar 23, 2020. [Accessed Mar 24, 2020]

  3. Clinicaltrials.gov. A study of venetoclax in combination with azacitidine versus azacitidine in treatment naïve subjects with acute myeloid leukemia who are ineligible for standard induction therapy. https://clinicaltrials.gov/ct2/show/NCT02993523. Updated Feb 28, 2020. [Accessed Mar 24, 2020]

  4. PR Newswire. AbbVie provides update from phase 3 study evaluating VENCLEXTA® (venetoclax) in combination with low-dose cytarabine in newly-diagnosed patients with acute myeloid leukemia (AML). https://www.prnewswire.com/news-releases/abbvie-provides-update-from-phase-3-study-evaluating-venclexta-venetoclax-in-combination-with-low-dose-cytarabine-in-newly-diagnosed-patients-with-acute-myeloid-leukemia-aml-301013711.html. Published Feb 28, 2020. [Accessed Mar 24, 2020]

Your opinion matters

HCPs, what is your preferred format for educational content on the AML Hub?
15 votes - 78 days left ...

Newsletter

Subscribe to get the best content related to AML delivered to your inbox