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Age Considerations for Findings on Venetoclax Combined With CLIA for AML, High-Risk MDS


Patrick Reville, MD, MPH, instructor, Department of Leukemia, MD Anderson Cancer Center, explains the implications of the longer-term follow-up of venetoclax in combination with the chemotherapy regimen cladribine, high-dose cytarabine, idarubicin (CLIA) and how age is a factor when considering chemotherapy options.

Longer-term outcomes seem to continue showing really encouraging results for the use of venetoclax in combination with the chemotherapy regimen cladribine, high-dose cytarabine, idarubicin (CLIA) in patients with newly-diagnosed acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS), said Patrick Reville, MD, MPH, instructor, Department of Leukemia, MD Anderson Cancer Center.


Were there any differences in results due to the longer-term follow-up in this study?

We're doing 2 things here. We have accrued more patients onto this study than per our last publication or our last presentation. So, we have more patients on the study today than we had in our publication or at the last time that we presented this at [the American Society of Hematology Annual Meeting & Exposition].

In addition, we have longer follow-up, so we have more patients and longer follow-up for especially the patients that had been on the study previously. The activity of the regimen is really confirmed with the additional patients. So, the response rate and how deep the responses are have been confirmed with the enrollment of more patients onto this study. That was really encouraging to see.

The longer-term outcomes seem to continue to show really encouraging results. We're not seeing many late relapses, or many late treatment failures on this study. Many of the earlier findings that we had shown before are really continuing to hold up at this later time point.

Based on these findings, are there any implications for older patients?

I think the first thing that needs to be done for anybody that's seeing these patients is that determination of whether they're eligible to receive intensive chemotherapy. The distinction is a lot [about] chronological age, but there are certainly patients that are young enough, just by the age cutoff, to have received intensive chemotherapy, but they may have other conditions that would make it such that intensive chemotherapy is not a good option. Any of those patients, either because of age or other comorbidities, I would say that this is not a regimen that would be applicable to them. In general, for the older patients or for the patients that are younger but are not eligible for intensive chemotherapy, this would not be a regimen that we should, at this time, use in those patients.

The other study does that. I think we have other regimens at MD Anderson that we're investigating, whereby we're hoping to improve the outcomes for those patients that are either older, or those that are ineligible for intensive chemotherapy.

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