Hypomethylating agent (HMA) plus venetoclax (VEN) regimens are standard of care in patients with acute myeloid leukemia (AML) ineligible for intensive chemotherapy. While the VEN label recommends continuous 28-day cycles, shortened VEN durations may induce similar response rates and improve tolerability. It is unknown how a VEN exposure reduced to 7 days during cycles compares to standard HMA + VEN. We retrospectively compared newly diagnosed AML patients treated with azacitidine (AZA) x 7 days plus VEN x 7 days (“7 + 7” regimen) from the first cycle (n = 82) vs patients treated with standard dose HMA + VEN (std-HMA/VEN) (n = 166). Composite complete remission rate was similar between cohorts (72% vs 72%; p = 0.95) and a median number of cycles to best response was 2 with “7 + 7” vs 1 with std-HMA/VEN (p = 0.03). Concerning toxicity, platelet transfusion rates during cycle 1 as well as early mortality at 8-weeks (6% vs 16%; p = 0.03) were lower in “7 + 7” cohort. Finally, the median OS was 11.2 months (2-year 28%) with “7 + 7” vs 10.3 months (2-year 34%) with “std-HMA/VEN” (p = 0.75). In summary, acknowledging limitations of a retrospective comparison, a shortened course of VEN used for 7 days every 28 days resulted in similar response rates and survival when compared to standard VEN exposure.
低甲基化剂（HMA）联合维奈克拉（VEN）方案是不适合强化化疗的急性髓系白血病（AML）患者的标准治疗方案。虽然维奈克拉说明书推荐连续28天给药周期，但缩短维奈克拉疗程可能获得相似的缓解率并提高耐受性。目前尚不清楚在治疗周期中将维奈克拉暴露时间缩短至7天与标准HMA联合维奈克拉方案相比效果如何。我们回顾性比较了首次周期接受阿扎胞苷（AZA）治疗7天联合维奈克拉治疗7天（“7+7”方案）的新诊断AML患者（n=82）与接受标准剂量HMA联合维奈克拉（std-HMA/VEN）治疗的患者（n=166）。两队列的复合完全缓解率相似（72% vs 72%；p=0.95），“7+7”方案达到最佳缓解的中位周期数为2，而std-HMA/VEN方案为1（p=0.03）。在毒性方面，“7+7”队列在第1周期的血小板输注率以及8周早期死亡率（6% vs 16%；p=0.03）较低。最终，“7+7”方案的中位总生存期为11.2个月（2年生存率28%），而std-HMA/VEN方案为10.3个月（2年生存率34%）（p=0.75）。总之，在认识到回顾性比较的局限性前提下，与标准维奈克拉暴露时间相比，每28天周期中使用7天的缩短维奈克拉疗程可获得相似的缓解率和生存结果。
肿瘤(癌症)患者之家