The Possibilities in AML With the FDA Approval of Azacitidine and Venetoclax

Brian A. Jonas, MD, discusses the future of treatment for older patients with acute myeloid leukemia (AML), now that the FDA has granted approval to azacitidine plus venetoclax for patients aged 75 years or older.

Jonas states that many oncologists in the academic setting already consider azacitidine plus venetoclax to be the new standard of care for older patients with AML. The results of the phase 3 VIALE-A study, which led to the FDA approval, demonstrated the ability of this combination for the large majority of patients. Jonas explains, however, that there are still some patients who do not benefit or relapse. For these patients, there may be an opportunity to add on another drug to the regimen.

In addition to azacitidine plus venetoclax becoming a backbone for a new regimen, the future may also hold promise for better toxicity management, explain Jonas. Cytopenias occurred often in the study and required specific strategies to improve patient outcomes. Because these toxicities are of concern for older patients, Jonas suggests re-working the combination to limited toxicity.