VEN + IVO + AZA Combination Therapy in IDH1-Mutated AML, MDS & MPNs | Jennifer Marvin Peek, MD | #ASH24

So one of the important abstracts that I wanted to talk about was an oral presentation that I gave on Saturday on a phase one and two clinical trial with Courtney DiNardo at MD Anderson, looking at a combination of three different agents for patients that have a diagnosis of either acute myeloid leukemia, myelodysplastic syndrome, or mild proliferative neoplasms with IDH1 mutations.

And so this clinical trial was looking at a combination of Ivosidenib, which is a targeted agent against the IDH1 mutation, Venetoclax, another oral pill that you can take for acute myeloid leukemia, as well as Azacitidine, which is either an IV or a subcutaneous injection. That is sometimes used for myelodysplastic syndromes and AML. And so we were looking at the combination of these agents for our patients.

So the way that the kind of clinical trial worked as we started with two of the agents together, because they wanted to confirm the safety of it for patients. And so we started with the Ivosidenib and the Venetoclax together. And once that was confirmed that that was safe for patients, we added in the third agent together.

And so we found that patients who received this combination of medications that 93% of them were able to achieve a remission within five cycles. So we were really, really excited about those results. And we have follow up now for over three years on patients on average. And we still have not reached what we call the median overall survival.

So after that three year period, we sit there is still 71% of patients that are alive and doing well on the therapy. You know, right now we have two regimens that are approved for patients with IDH1 mutated hematologic malignancies. There's the combination of Azacitidine and venetoclax that has overall patients do really well. And then there's the other combination of Azacitidine and the IIvosidenib which also patients do fairly well.

But even with that, you know, there's still about half of patients that don't get a response on those therapies. And so what I'm hoping for is that future trials will really look at comparing in a randomized fashion. You know, this triplet combination of therapy compared to some of the doublets, to see if it can overall improve responses for patients.

Seeing more patients you know, doing well, living longer. And hopefully being able to get to transplant and other kind of definitive therapies.