2019
DOI: 10.1182/blood-2019-128909
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Outcomes of Relapsed or Refractory Acute Myeloid Leukemia after Frontline Hypomethylating Agent with Venetoclax Regimens

Abstract: Background: Acute myeloid leukemia (AML) outcomes in the elderly, particularly intensive chemotherapy (IC)-ineligible patients (pts), are poor. Venetoclax (VEN), a BCL2 inhibitor, in combination with low-intensity regimens has shown excellent efficacy in AML and is approved for IC-ineligible pts as frontline therapy. Outcomes and expectations of AML after failure of frontline VEN-based regimens are unknown. Methods: We conducted a retrospective study to determine pt outcomes after failure of fro… Show more

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Cited by 29 publications
(50 citation statements)
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“…39,40 The approval was based on a phase 1/2 trial. 29 Here, enasidenib monotherapy achieved an ORR of 40.3%, with a median dura tion of response of 5.8 months and a median OS of 9.3 months in R/R IDH2-mutated AML patients. 40 GO also received approval by the FDA (not the EMA) for R/R patients with CD33 + AML and can be added to inten sive ther apy.…”
Section: Treatment Of Aml In Relapsementioning
confidence: 79%
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“…39,40 The approval was based on a phase 1/2 trial. 29 Here, enasidenib monotherapy achieved an ORR of 40.3%, with a median dura tion of response of 5.8 months and a median OS of 9.3 months in R/R IDH2-mutated AML patients. 40 GO also received approval by the FDA (not the EMA) for R/R patients with CD33 + AML and can be added to inten sive ther apy.…”
Section: Treatment Of Aml In Relapsementioning
confidence: 79%
“…Unfortunately, a ret ro spec tive anal y sis sug gests that once patients become unre spon sive to HMA/VEN the prog no sis is very poor. 29 This might be related to the acqui si tion of high-risk cytoge netic and molec u lar fea tures (eg, muta tions in TP53, N/KRAS, and/or KIT). 29 For patients who are older but lack comorbidities, the ques tion arises as to whether inten sive ther apy or HMA/VEN treat ments are the wiser treat ment choice.…”
Section: Nonintensive Ther Apy With Novel Agentsmentioning
confidence: 99%
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“…After patients attain remission with VENbased therapy, we periodically monitor the ongoing response using bone marrow biopsies performed every 3-6 months, and we routinely test for MRD to identify early relapse. Patients relapsing after VEN-based therapy have a poor prognosis, as demonstrated by Maiti et al, 41 and such patients should be referred for clinical trials.…”
Section: Duration Of Venetoclax-based Therapy and Allohct After Ven-hmamentioning
confidence: 99%
“…However, although the majority of patients will respond to this new standard regimen, relapses still occur with more resistant clones. Those who lose their responses after HMA−venetoclax combinations will have a dismal outcome and a median OS of 2.4 months regardless of salvage treatment used [9]. Strategies to improve further the long-term outcomes of venetoclax-based combinations and reach a potential cure for older AML adults are much needed.…”
mentioning
confidence: 99%