BACKGROUND: Relapsed/refractory (R/R) acute myeloid leukemia (AML) has poor outcomes. Although lower-intensity venetoclax-containing regimens are standard for older/unfit patients with newly diagnosed AML, it is unknown how such regimens compare with intensive chemotherapy (IC) for R/R AML. METHODS: Outcomes of R/R AML treated with 10-day decitabine and venetoclax (DEC10-VEN) were compared with IC-based regimens including idarubicin with cytarabine, with or without cladribine, clofarabine, or fludarabine, with or without additional agents. Propensity scores derived from patient baseline characteristics were used to match DEC10-VEN and IC patients to minimize bias. RESULTS: Sixty-five patients in the DEC10-VEN cohort were matched to 130 IC recipients. The median ages for the DEC10-VEN and IC groups were 64 and 58 years, respectively, and baseline characteristics were balanced between the 2 cohorts. DEC10-VEN conferred significantly higher responses compared with IC including higher overall response rate (60% vs 36%; odds ratio [OR], 3.28; P < .001), complete remission with incomplete hematologic recovery (CRi, 19% vs 6%; OR, 3.56; P = .012), minimal residual disease negativity by flow cytometry (28% vs 13%; OR, 2.48; P = .017), and lower rates of refractory disease. DEC10-VEN led to significantly longer median event-free survival compared with IC (5.7 vs 1.5 months; hazard ratio [HR], 0.46; 95% CI, 0.30-0.70; P < .001), as well as median overall survival (OS; 6.8 vs 4.7 months; HR, 0.56; 95% CI, 0.37-0.86; P = .008). DEC10-VEN was independently associated with improved OS compared with IC in multivariate analysis. Exploratory analysis for OS in 27 subgroups showed that DEC10-VEN was comparable with IC as salvage therapy for R/R AML. CONCLUSION: DEC10-VEN represents an appropriate salvage therapy and may offer better responses and survival compared with IC in adults with R/R AML.
BACKGROUND: Relapsed/refractory (R/R) acute myeloid leukemia (AML) has poor outcomes. Although lower-intensity venetoclax-containing regimens are standard for older/unfit patients with newly diagnosed AML, it is unknown how such regimens compare with intensive chemotherapy (IC) for R/R AML. METHODS: Outcomes of R/R AML treated with 10-day decitabine and venetoclax (DEC10-VEN) were compared with IC-based regimens including idarubicin with cytarabine, with or without cladribine, clofarabine, or fludarabine, with or without additional agents. Propensity scores derived from patient baseline characteristics were used to match DEC10-VEN and IC patients to minimize bias. RESULTS: Sixty-five patients in the DEC10-VEN cohort were matched to 130 IC recipients. The median ages for the DEC10-VEN and IC groups were 64 and 58 years, respectively, and baseline characteristics were balanced between the 2 cohorts. DEC10-VEN conferred significantly higher responses compared with IC including higher overall response rate (60% vs 36%; odds ratio [OR], 3.28; P < .001), complete remission with incomplete hematologic recovery (CRi, 19% vs 6%; OR, 3.56; P = .012), minimal residual disease negativity by flow cytometry (28% vs 13%; OR, 2.48; P = .017), and lower rates of refractory disease. DEC10-VEN led to significantly longer median event-free survival compared with IC (5.7 vs 1.5 months; hazard ratio [HR], 0.46; 95% CI, 0.30-0.70; P < .001), as well as median overall survival (OS; 6.8 vs 4.7 months; HR, 0.56; 95% CI, 0.37-0.86; P = .008). DEC10-VEN was independently associated with improved OS compared with IC in multivariate analysis. Exploratory analysis for OS in 27 subgroups showed that DEC10-VEN was comparable with IC as salvage therapy for R/R AML. CONCLUSION: DEC10-VEN represents an appropriate salvage therapy and may offer better responses and survival compared with IC in adults with R/R AML.
Authors: Nicholas J Short; Hind Rafei; Naval Daver; Hyunsoo Hwang; Jing Ning; Jeffrey L Jorgensen; Tapan M Kadia; Courtney D DiNardo; Sa A Wang; Elias Jabbour; Uday Popat; Betul Oran; Jorge Cortes; Marina Konopleva; Musa Yilmaz; Ghayas C Issa; Hagop Kantarjian; Farhad Ravandi Journal: Blood Adv Date: 2020-12-22
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Authors: Courtney D DiNardo; Abhishek Maiti; Caitlin R Rausch; Naveen Pemmaraju; Kiran Naqvi; Naval G Daver; Tapan M Kadia; Gautam Borthakur; Maro Ohanian; Yesid Alvarado; Ghayas C Issa; Guillermo Montalban-Bravo; Nicholas J Short; Musa Yilmaz; Prithviraj Bose; Elias J Jabbour; Koichi Takahashi; Jan A Burger; Guillermo Garcia-Manero; Nitin Jain; Steven M Kornblau; Philip A Thompson; Zeev Estrov; Lucia Masarova; Koji Sasaki; Srdan Verstovsek; Alessandra Ferrajoli; William G Weirda; Sa A Wang; Sergej Konoplev; Zhining Chen; Sherry A Pierce; Jing Ning; Wei Qiao; Farhad Ravandi; Michael Andreeff; John S Welch; Hagop M Kantarjian; Marina Y Konopleva Journal: Lancet Haematol Date: 2020-09-05 Impact factor: 18.959
Authors: Abhishek Maiti; Wei Qiao; Koji Sasaki; Farhad Ravandi; Tapan M Kadia; Elias J Jabbour; Naval G Daver; Gautam Borthakur; Guillermo Garcia-Manero; Sherry A Pierce; Kathryn S Montalbano; Naveen Pemmaraju; Kiran Naqvi; Maro Ohanian; Nicholas J Short; Yesid Alvarado; Koichi Takahashi; Musa Yilmaz; Nitin Jain; Steven M Kornblau; Michael Andreeff; Prithviraj Bose; Alessandra Ferrajoli; Ghayas C Issa; Lucia Masarova; Philip A Thompson; Caitlin R Rausch; Jing Ning; Hagop M Kantarjian; Courtney D DiNardo; Marina Y Konopleva Journal: Am J Hematol Date: 2020-12-24 Impact factor: 10.047
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Authors: Maximilian Fleischmann; Sebastian Scholl; Jochen J Frietsch; Inken Hilgendorf; Karin Schrenk; Jakob Hammersen; Florian Prims; Christian Thiede; Andreas Hochhaus; Ulf Schnetzke Journal: J Cancer Res Clin Oncol Date: 2022-01-31 Impact factor: 4.322