ASH 2023: Expanding AML Remissions with HMA's and Venetoclax

Dr. Tapan Kadia from the MD Anderson Cancer Center stopped by to tell us about some of the exciting research he is working on. Read below to learn about his exciting work or watch the video to hear it from Dr. Kadia himself. 

Maintenance Therapy

Oral azacitidine has recently been approved for use as maintenance therapy for AML patients. Maintenance therapy is ongoing medication given to patients after their cancer has responded positively to cancer treatment. Azacitidine has been shown to improve survival in patients who reach remission, but do not qualify for stem cell transplant. With that success in mind, Dr. Kadia and his team are researching two different ways to increase the efficacy of maintenance therapy to extend remission for AML patients. 

Azacitidine and Venetoclax

In their first study, they looked at using azacitidine and venetoclax as maintenance therapy. Overall, they saw positive results in patients in remission. The combination of azacitidine and venetoclax was well tolerated by patients and delivered in lower doses than what newly diagnosed patients are typically given in the course of their treatment. They saw the combination as particularly effective in patients with the IDH1, IDH2 and NPM1 mutations. 

Oral Decitabine Combination

In their second study, they used oral decitabine in combination with another agent as maintenance therapy in an effort to extend remission. This combination therapy is more nuanced as the other agent used in combination with decitabine is determined by the patient's genetic profile:

• IDH1 mutated - decitabine and ivosidenib
• IDH2 mutated - decitabine and enasidenib 
• FLT3 mutated - decitabine and gilteritinib
• Other mutations: decitabine alone or decitabine and venetoclax

This study is showing positive early results. Patients are finding the regimen tolerable and so far very few patients have experienced a relapse.

Conclusion

Dr. Kadia and his team at MD Anderson are exploring methods of maintenance therapy with the goal of extending remission in patients who do not qualify for a stem cell transplant. So far, both studies Dr. Kadia shared with us are showing positive results with patients seeing longer remissions. We will excitedly continue to follow these studies and report on updates as further results are shared. 

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