Venetoclax-based salvage therapy as a bridge to transplant is feasible and effective in patients with relapsed/refractory AML
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
Abstract
The B-cell lymphoma 2 inhibitor venetoclax (VEN) in combination with hypomethylating agents has been approved for first-line treatment of patients with acute myeloid leukemia (AML) ineligible for intensive treatment. VEN-containing treatment strategies may also be effective in relapsed/refractory (R/R) AML; however, comparative studies with conventional therapies for fit patients as a bridge-to-transplant strategy are limited. Using propensity score matching (PSM), we compared 37 patients with R/R AML, who received VEN-based salvage therapy as bridge to allogeneic hematopoietic stem cell transplantation (allo-HCT), with 90 patients from the German Study Alliance Leukemia AML registry, who were treated with non-VEN-containing salvage therapy according to their treating physician's choice (TPC). The overall response rate among VEN patients was higher than the TPC control cohort (62% vs 42%; P = .049). Overall, 73% of VEN-treated patients vs 63% of TPC patients were bridged to allo-HCT (P = .41). After a median follow-up of 34.3 months for the VEN and 21.0 months for the TPC cohort, the median overall survival (OS) were 15.8 months (95% confidence interval [CI], 10.6 to not evaluable) and 10.5 months (95% CI, 6.8-19.6; P = .15), respectively. PSM revealed a trend toward improved OS for VEN patients (hazard ratio, 0.70; 95% CI, 0.41-1.22; P = .20). Median event-free survival was significantly longer in the VEN cohort (8.0 months) than the TPC cohort (3.7 months; P = .006). Our data suggest that VEN-based salvage therapy is a safe and effective bridge to allo-HCT for this difficult-to-treat AML patient population.
Details
Original language | English |
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Pages (from-to) | 375-385 |
Number of pages | 11 |
Journal | Blood advances |
Volume | 9 |
Issue number | 2 |
Publication status | E-pub ahead of print - 18 Sept 2024 |
Peer-reviewed | Yes |
External IDs
unpaywall | 10.1182/bloodadvances.2024013086 |
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Scopus | 85216469361 |
Mendeley | 14ac513a-8d0b-3633-b295-ee8e0a9d90e0 |
Keywords
Keywords
- Recurrence, Humans, Salvage Therapy/methods, Middle Aged, Antineoplastic Agents/therapeutic use, Hematopoietic Stem Cell Transplantation, Leukemia, Myeloid, Acute/therapy, Male, Treatment Outcome, Drug Resistance, Neoplasm, Sulfonamides/therapeutic use, Bridged Bicyclo Compounds, Heterocyclic/therapeutic use, Female, Adult, Aged