613. Acute Myeloid Leukemia: Clinical Studies: Non-Intensive Therapy


Conclusion cited from the abstract:  

ENA + AZA was associated with significantly improved complete remission and overall response rates and significant mIDH2 VAF reductions compared with AZA-only. Combination Tx was generally well tolerated, with a safety profile similar to that reported for either monotherapy. An updated data cutoff that includes at least 1 year of follow-up for all pts will be presented at the conference. Updated data will include overall survival, event-free survival, and comprehensive analyses of 2-HG and co-mutation dynamics.




Conclusion cited from the abstract:  These multicenter prospective data provide further strong evidence that continuous MRD monitoring is feasible and can identify MDS/AML pts at high risk of hematological relapse. Pre-emptive MRD-guided therapy with AZA is an effective treatment to prevent or at least substantially delay hematologic relapse in these pts.




Conclusion cited from the abstract:  DEC10-VEN is an effective regimen for AML. Addition of FLT3i to DEC10-VEN was safe and may improve upon responses in FLT3mut pts. Mutations in NPM1 and DNA methylation pathways were associated with more durable responses while mutations in ASXL1, RAS and TP53 were associated with refractory disease or relapse.




Conclusion cited from the abstract:  We report one of the largest datasets examining the outcomes of older AML pts receiving HMAs in real-world setting. Population-level median OS observed with DEC was similar to that of DACO-016 trial (8.3 vs. 7.7 mos), while that for AZA was shorter than AML-001 trial (7.1 vs. 10.4 mo). The difference could be related to the trial designs (e.g. AML-001 allowed healthier, including IC-eligibile older pts) or suboptimal use of AZA in the community. One third of pts with RBC TD achieved TI with HMA therapy, with no difference between the 2 agents. While DEC appeared to confer an OS advantage compared to AZA, the absolute difference was small. Most pts did not complete >4 HMA cycles suggesting that combination HMA-based therapies with shorter time to response may be helpful to improve outcomes in this difficult-to-treat pt population.




Conclusion cited from the abstract:  AML-MRC is a heterogeneous group of AML with diverse mutational abnormalities and outcomes. Selection of therapy should be based on cytogenetic abnormalities and AML-MRC subtype.




Conclusion cited from the abstract:  WBC count and PS are the main predictors for ED in unfit AML patients treated by HMAs. A new tool (HMA-EDS) discriminates two different risk groups and supersedes other previously published prognostic systems (Walter’s, Wheatley’s MRC/LRF, ALFA and ALMA) for this purpose. This score could be useful to select patients for front-line HMA or even HMAs-based combination therapies, given that several cycles are usually needed to achieve a clinical response. We suggest that other patient-related covariates such as geriatric assessment be checked in future studies.