Treatment-free remission after ceasing venetoclax-based therapy in patients with acute myeloid leukemia.
Treatment-free remission after ceasing venetoclax-based therapy in patients with acute myeloid leukemia.
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DOI：
10.1182/bloodadvances.2022007083
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发表时间：
2022-07-12
期刊：
影响因子：
7.5
通讯作者：
Wei, Andrew H.
中科院分区：
文献类型：
--
作者：
Chua, Chong Chyn;Hammond, Danielle;Kent, Andrew;Tiong, Ing Soo;Konopleva, Marina Y.;Pollyea, Daniel A.;DiNardo, Courtney D.;Wei, Andrew H.
接受 ≥12 个月基于 VEN 的治疗的一部分患者在停止治疗后可以经历持久的免治疗缓解。复发风险、无复发生存期和总生存期与持续治疗直至进展的患者队列相似。 3 期研究已证实，在低甲基化药物或低剂量阿糖胞苷中添加维奈托克 (VEN) 对于老年和/或身体不适的新诊断急性髓系白血病 (AML) 患者具有临床益处。随着 AML 患者越来越多地采用基于 VEN 的疗法，一个相关的问题是，在已实现持续缓解的患者中是否可以安全地停止治疗。我们假设一部分选择停止治疗的患者可能会受益于无需无限期治疗的无治疗缓解期（TFR）。我们报告了 29 名接受基于 VEN 的治疗缓解至少 12 个月的患者的回顾性结果，其中 55% 的患者继续治疗直至疾病进展，45% 的患者选择性停止治疗 (STOP)。经过超过 5 年的随访，我们观察到 STOP 队列中的中位 TFR 持续 45.8 个月，超过 50% 的患者在数据截止时仍处于持续缓解状态。两个队列之间的复发风险、无复发持续时间和总生存期相似。队列中有利于持续 TFR 的因素包括诊断时的 NPM1 和/或 IDH2 突变、完全缓解且没有可测量的残留疾病，以及停止治疗前至少 12 个月的基于 VEN 的联合治疗。
A subset of patients receiving ≥12 months of VEN-based therapy can experience durable treatment-free remission after ceasing therapy. The risk of relapse, duration of relapse-free survival, and overall survival were similar to a cohort of patients continuing therapy until progression. The clinical benefit of adding venetoclax (VEN) to hypomethylating agents or low-dose cytarabine in older and/or unfit patients with newly diagnosed acute myeloid leukemia (AML) has been confirmed in phase 3 studies. With the increased uptake of VEN-based therapies for patients with AML, a pertinent question is whether treatment can be safely ceased among patients who have achieved sustained remission. We hypothesized that a proportion of patients opting to cease therapy may benefit from a treatment-free remission (TFR) period without indefinite treatment. We report the retrospective outcomes of 29 patients in remission for a minimum of 12 months on VEN-based therapy, with 55% continuing therapy until disease progression and 45% electively ceasing treatment (STOP). With follow-up exceeding 5 years, we observed a median TFR lasting 45.8 months among the STOP cohort, with >50% of patients still in sustained remission at the data cutoff. The risk of relapse and duration of relapse-free and overall survival were similar between the 2 cohorts. Factors favoring sustained TFR within the cohort included NPM1 and/or IDH2 mutation at diagnosis, complete remission without measurable residual disease, and at least 12 months of VEN-based combination therapy prior to treatment cessation.
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影响因子：
7.5
作者：
Patel, Kishan K.;Zeidan, Amer M.;Huntington, Scott F.
通讯作者：
Huntington, Scott F.
DOI：
10.1200/jco.21.01546
发表时间：
2022-03-10
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
--
作者：
Pratz KW;Jonas BA;Pullarkat V;Recher C;Schuh AC;Thirman MJ;Garcia JS;DiNardo CD;Vorobyev V;Fracchiolla NS;Yeh SP;Jang JH;Ozcan M;Yamamoto K;Illes A;Zhou Y;Dail M;Chyla B;Potluri J;Döhner H
通讯作者：
Döhner H
影响因子：
51.1
作者：
DiNardo, Courtney L.;Pratz, Keith W.;Pollyea, Daniel A.
通讯作者：
Pollyea, Daniel A.
影响因子：
6.2
作者：
Zeidan, Amer M.;Podoltsev, Nikolai A.;Wang, Rong
通讯作者：
Wang, Rong
影响因子：
45.3
作者：
Wei, Andrew H.;Strickland, Stephen A., Jr.;Roboz, Gail J.
通讯作者：
Roboz, Gail J.