Older AML Treatment: New Insights From ASH! | Ira Zackon, MD

Hi, I'm Dr. Ira Zaycon. I'm a senior medical director with ONTATA, and this is an organization with which we conduct what's called real-world research. So research on data that we're able to use on the everyday care of people in the community setting, okay, our databases at community oncology practices. And so I'm here at the annual ASH meeting, and we have a research abstract on patients with acute myeloid leukemia, or AML it's called, for those familiar with it. But we're primarily interested in AML patients who are older, because this has always presented a more challenging, you know, the standard of therapy for decades was fairly intensive chemotherapy, and it was not easy to deliver in older patients. It was more complicated. Sometimes it could be, you know, make life worse than better. But we've seen in recent years a shift to what we call non-intensive therapies, and most commonly currently it's using an injectable medication that is not a chemotherapy. It doesn't have all those chemotherapy side effects, but it works to get the leukemia cells to stop doing some of their bad behavior and sometimes become more productive members of the cell of our blood-making system in the bone marrow. But in combination with an oral pill that is called Venatoclax, which kind of hastens the malignant cell going into its own cell death, okay? Or a chemotherapy that talks into the cell. This is trying to push it to its natural ways that it might die, okay? And that's how it treats the leukemia. So there's been a real shift to this type of therapy, and it was approved in 2020, this combination of therapy for patients who are 75 or older, or younger than that, but felt to be unfit, not in good enough shape to get more intensive therapy for AML. So we looked at our database at AML patients who were 70 years or older and had received this type of therapy as their primary therapy for leukemia. And to our knowledge, this is the largest database at the community level, at least looking at how these patients are doing. So what we saw was that we had almost 1,100 patients on this study, so a good number to represent what's happening. And when we looked at the overall survival, we saw encouragingly that, first of all, the median age was about 77, so again, an older population. When we first looked at actually how long patients were on therapy, we saw that it was stopped on average earlier than what the trials did, so that reflects the real world. It's not always to deliver therapy in the same way just because patients might be older. And in fact, this patient's population was significantly older than what was studied, again, so that's why it's the importance of looking in the real world, or what we call the real world, everyday care. And so, but patients were able to be treated at least across this age spectrum of 70, even to 85 plus, a fairly similar way. So we know that it's tolerable in the elderly population across the age spectrum. When we look at what we call overall survival, how long patients with AML lived, you know, our median, we'll call the median the average, was just under a year. But in the trials, it was maybe about 15 months, so although less than that, it was close. And I think that was encouraging to see that we can deliver this. And these are therapies that will ultimately improve, because there's actually, you know, when you take on new therapies in the community, you also have to learn some of the nuances of the drugs and side effects and how to dose it, and you continually get better at that. So you know, we can anticipate that we may see patients on therapy longer, safer, and maybe achieve, you know, improved outcomes. This is the beginning, you know, it's been a challenge in AML, but to have this therapy available we didn't have, there wouldn't have been an option to really treat patients and achieve complete remissions and prolong people's lives in a meaningful way. Obviously, we always want to do better, and that's why research is important to continue to develop new options, of which there are. We have new ways of targeting leukemia cells in some patients that, you know, we couldn't do before. So that's what these meetings are all about, trying to make things better and let the scientists and the physicians know what's new. If our videos have helped you in any way, and you're able to, please consider making a donation to help us continue this important work. Your gift will go three times as far when we reach $500,000 by the end of the year. Every contribution, big or small, makes a difference, and we're deeply grateful for your support.