Venetoclax and Azacitidine in Newly Diagnosed AML Patients | Dan Pollyea, MD, MS | ASH 2022

Hi, I'm Dan Paglia, Professor of Medicine at the University of Colorado and here at the ASH 2022 meeting. And I'm very excited about a lot of work that folks are presenting. Some of our work that was presented here includes a new way to prognosticate patients with newly diagnosed acute myeloid leukemia who are receiving treatment with the new regimen of venetoclax plus azacytidine. So historically, patients have been prognosticated with newly diagnosed AML with an accepted prognostic scheme or criteria that's really based on patients who have received intensive induction chemotherapy. And now that we have another treatment, venetoclax plus azacytidine, for patients who aren't eligible for induction chemotherapy, we thought that we would need to update the classification systems, the prognostic classification systems, to better account for outcomes for patients who receive this new therapy. And so we first showed that indeed the classical way of prognosticating patients doesn't apply to venetoclax patients. So that was good to see. That was our assumption. And then we came up with a new classification system to create three different risk groups, a favorable, an intermediate, and a poor risk group for patients receiving venetoclax plus azacytidine. And it was fairly simple the way this worked out. It's all based on the status of four different gene mutations. The presence or absence of these four gene mutations can put a patient into one of these three categories. So this is a really important first step to be able to better predict patients on this new regimen, who will do well, who will do poorly. And that's the first step in being able to intervene and modify the therapy for patients who, for instance, aren't expected to do well versus leave the therapy as is for patients that we think are going to do well. So we're very happy about this preliminary step, and we're very happy to share it here at the ASH meeting. I think what patients should be aware of now are some emerging therapies targeting a protein called menin. And this is relevant for patients with particular chromosomal abnormalities. One is called KNT2A, and the other is an NPM1 mutation. So these patients who have those abnormalities may be eligible to receive a menin inhibitor. And we just saw results from two clinical trials showing that these are very promising therapies for those subsets of AML patients. So it's definitely something to be excited about to keep looking at in the near future.