Combination of Venetoclax and Hypomethylating Agents Show Efficacy in AML

Danielle Hammond, MD, a clinical fellow in leukemia for the MD Anderson Cancer Center Leukemia Fellowship Program at The University of Texas MD Anderson Cancer Center, discusses the results from a retrospective review of patients with acute myeloid leukemia (AML) treated over the last 6 years with a combination of venetoclax (Venclexta) and either decitabine or azacitadine.

This combination was highly effective in patients with IDH-mutated AML in the front line with a complete response (CR) and CR with incomplete hematologic recovery (CRi) rate of about 88%, according to Hammond. The patients with relapsed/refractory disease had a CR and CRi rate of close to 50%.

Using flow cytometry for minimal residual disease (MRD) testing in the patients receiving frontline treatment, investigators found that almost 90% of the patients who responded to treatment had MRD negativity. Hammond says what is interesting is that half of the responding patients, despite being MRD negative by flow cytometry, still had a detectable IDH mutation when using next generation sequencing. This suggests there may be a role for combination therapy with the FDA approved IDH1 and IDH2 inhibitors, she concluded.