Gabriel Mannis, MD
After a 40-year treatment paradigm with little to no change, 2017 saw 4 regulatory approvals in the field of acute myeloid leukemia (AML).
on Hematologic Malignancies, Gabriel Mannis, MD, an assistant professor of hematology and blood and marrow transplantation, University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, discussed novel therapies shifting the treatment paradigm for patients with AML.
OncLive: Please provide an overview of your presentation on novel therapies in AML.
The treatment of AML has essentially been the same for the last 40 years since the development of 7+3 chemotherapy. Over the past 30 years, the main improvements that have been attempted have been various additions or modifications to 7+3. Over 4 decades, none have been shown to improve outcomes for patients with AML.
Finally, of the 4 FDA-approved drugs, gemtuzumab ozogamicin (Mylotarg) was initially approved over a decade ago and was taken off the market. It has now been reapproved by the FDA after further studies show that a lower dose improves OS when added to 7+3 chemotherapy. The groups who benefitted were those with favorable- and intermediate-risk AML. While it benefitted patients of all ages, it is likely to be used in favorable-risk patients with AML in combination with 7+3 chemotherapy.
Reflecting on the 2017 ASH Annual Meeting, what were some exciting abstracts in AML?
One of the exciting things from the meeting was the emerging data about venetoclax (Venclexta) in AML. Venetoclax was FDA approved for the treatment of relapsed/refractory CLL, but it is being studied in combination with both hypomethylating agents and cytarabine for the treatment of elderly patients who are not fit for intensive chemotherapy. Those patients now are likely to get single-agent hypomethylating treatments or low-dose cytarabine with response rates of 20% to 30%.
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