Vincent: A randomized-controlled trial evaluating venetoclax plus azacitidine versus intensive chemotherapy in patients with newly diagnosed, NPM1-mutated AML

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Lydia Kretschmer - , Department of Internal Medicine I (Author)
  • Leo Ruhnke - , Department of Internal Medicine I (Author)
  • Christoph Schliemann - , University Hospital Münster (Author)
  • Lars Fransecky - , University Hospital Schleswig-Holstein Campus Kiel (Author)
  • Björn Steffen - , University Hospital Frankfurt (Author)
  • Martin Kaufmann - , Robert Bosch Krankenhaus Stuttgart (Author)
  • Andreas Burchert - , University Hospital Gießen and Marburg (Author)
  • Christoph Schmid - , University Hospital Augsburg (Author)
  • Maher Hanoun - , University Hospital Essen (Author)
  • Tim Sauer - , University Hospital Heidelberg (Author)
  • Klaus H Metzeler - , University Hospital Leipzig (Author)
  • Kerstin Schäfer-Eckart - , Paracelsus Medical University Nuremberg (Author)
  • Mathias Hänel - , Klinikum Chemnitz gGmbH (Author)
  • Martina Crysandt - , Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) (Author)
  • Paul Jäger - , University Hospital Duesseldorf (Author)
  • Stefan W Krause - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Christine Dierks - , Martin Luther University Hospital (Author)
  • Stefan Klein - , Universitätsmedizin Mannheim (Author)
  • Nadia Maguire - , Hospital of the Brothers of Mercy Regensburg (Author)
  • Lukas P Frenzel - , University Hospital Cologne (Author)
  • Veit L Bücklein - , Hospital of the Ludwig-Maximilians-University (LMU) Munich (Author)
  • Wolfgang Blau - , Helios HSK Clincs Wiesbaden (Author)
  • Ulrich Kaiser - , St. Bernward Hospital (Author)
  • Kai Wegehenkel - , University Hospital Bielefeld (Author)
  • Alexander Höllein - , Red Cross Hospital Munich (Author)
  • Ruth Seggewiss-Bernhardt - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Wenke Markgraf - , Department of Internal Medicine I (Author)
  • Frank Fiebig - , Department of Internal Medicine I (Author)
  • Anna Harig - , Department of Internal Medicine I (Author)
  • Katharina Schmidt-Brücken - , Department of Internal Medicine I (Author)
  • Christian Thiede - , Department of Internal Medicine I, AgenDix GmbH (Author)
  • Jan Moritz Middeke - , Department of Internal Medicine I (Author)
  • Richard Dillon - , King's College London (KCL) (Author)
  • Claudia D Baldus - , University Hospital Schleswig-Holstein Campus Kiel (Author)
  • Hubert Serve - , University Hospital Frankfurt (Author)
  • Karsten Spiekermann - , Hospital of the Ludwig-Maximilians-University (LMU) Munich (Author)
  • Wolfgang Hiddemann - , Hospital of the Ludwig-Maximilians-University (LMU) Munich (Author)
  • Richard F Schlenk - , University Hospital Heidelberg (Author)
  • Carsten Müller-Tidow - , University Hospital Heidelberg (Author)
  • Martin Bornhäuser - , Department of Internal Medicine I (Author)
  • Christoph Röllig - , Department of Internal Medicine I (Author)

Abstract

For younger, medically fit patients with NPM1-mutated, FLT3-wildtype acute myeloid leukemia (AML) intensive chemotherapy represents standard of care (SOC), with complete remission (CR) rates observed in up to 85% of patients and 5-year overall survival (OS) rates of 40-50%. However, significant toxicity and need for hospitalization pose challenges on patients' outcome and quality of life (QoL). Venetoclax (VEN) combined with azacitidine (AZA) has demonstrated encouraging efficacy in older, unfit AML patients, achieving high CR/CRi rates and promising OS with lower toxicity. Prospective, randomized data comparing VEN/AZA to SOC in younger, fit patients are currently missing. VINCENT is a randomized-controlled, multicenter, non-inferiority, phase 2 trial (NCT05904106) evaluating VEN/AZA versus SOC in adults aged 18-70 years with newly diagnosed, NPM1-mutated, FLT3-wildtype AML. Patients medically fit for intensive chemotherapy (ECOG ≤ 2) with adequate organ function are eligible, while patients with relapsed/refractory AML or prior cytotoxic treatment are excluded. A total of 146 patients will be randomized 1:1 to receive either VEN/AZA or SOC. Hematologic remission is evaluated according to ELN 2022 guidelines. The primary endpoint is the modified event-free survival, defined as either primary induction failure, hematologic relapse, molecular failure or death. Secondary endpoints include safety, tolerability, CR/CRi/CRh/CRMRD- rates, MRD kinetics (using NPM1 RT-qPCR and MFC), relapse-free survival, OS, early mortality, health-related QoL and cumulative health-care-resource use. Patients will be followed up for at least two years post enrollment. The VINCENT trial will be the first study to provide comprehensive prospective data comparing VEN/AZA to SOC, addressing both efficacy and patient-centered outcomes.

Details

Original languageEnglish
Pages (from-to)3647-3654
Number of pages8
JournalAnnals of hematology
Volume104
Issue number7
Publication statusPublished - 9 Jul 2025
Peer-reviewedYes

External IDs

PubMedCentral PMC12334493
Scopus 105010088937

Keywords

ASJC Scopus subject areas

Keywords

  • AML, Azacitidine, Fit patients, Intensive chemotherapy, NPM1, Venetoclax