Therapeutic Advances in First-Line Management of Acute Myeloid Leukemia

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Daniel A. Pollyea
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Over the past several years, drug approvals for first-line treatment of acute myeloid leukemia have changed the landscape from a “wasteland” to an “embarrassment of riches.” In general, patients deemed “fit” for induction chemotherapy who have a core-binding factor abnormality should receive 7 + 3 in combination with gemtuzumab, 7 + 3 with midostaurin for those with an FLT3 abnormality, and liposomal cytarabine + daunorubicin for patients with secondary AML. Although other options exist, Dr. Daniel A. Pollyea recommended a venetoclax/azacitidine regimen for newly diagnosed “unfit” patients. Future research should focus on more clearly determining the definition of a “fit” patient, he said at the NCCN 2019 Annual Congress: Hematologic Malignancies.

Disclosures: Dr. Pollyea has disclosed that he is a scientific advisor for AbbVie, Inc., Agios, Inc., Celgene Corporation, Daiichi-Sankyo Co., Forty Seven, Inc., Janssen Pharmaceutica Products, LP, Pfizer Inc., and Takeda Pharmaceuticals North America, Inc.

Correspondence: Daniel A. Pollyea, MD, MS, University of Colorado Cancer Center, 1665 Aurora Court, Mail Stop F704, Aurora, CO 80045. Email: daniel.pollyea@ucdenver.edu
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  • 1.

    Hills RK, Castaigne S, Appelbaum F, et al.. Addition of gemtuzumab ozogamicin to induction chemotherapy in adult patients with acute myeloid leukaemia: a meta-analysis of individual patient data from randomised controlled trials. Lancet Oncol 2014;15:986996.

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    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Stone RM, Mandrekar SJ, Sanford BL, et al.. Midostaurin plus chemotherapy for acute myeloid leukemia with a FLT3 mutation. N Engl J Med 2017;377:454464.

  • 3.

    Lancet JE, Uy GL, Cortes JE, et al.. CPX-351 (cytarabine and daunorubicin) liposome for injection versus conventional cytarabine plus daunorubicin in older patients with newly diagnosed secondary acute myeloid leukemia. J Clin Oncol 2018;36:26842692.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Medeiros BC, Satram-Hoang S, Hurst D, et al.. Big data analysis of treatment patterns and outcomes among elderly acute myeloid leukemia patients in the United States. Ann Hematol 2015;94:11271138.

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    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Pollyea DA, Tallman MS, de Botton S, et al.. Enasidenib, an inhibitor of mutant IDH2 proteins, induces durable remissions in older patients with newly diagnosed acute myeloid leukemia [published online April 9, 2019]. Leukemia. doi: 10.1038/s41375-019-0472-2

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    • Search Google Scholar
    • Export Citation
  • 6.

    Westervelt P, Roboz GJ, Cortes JE, et al.. Safety and clinical activity of AMV564, a CD33/CD3 T-cell engager, in patients with relapsed/refractory acute myeloid leukemia (AML): updated results from the phase 1 first-in-human trial [abstract]. Presented at the European Hematology Association 24th Annual Meeting; June 13–16, 2019; Amsterdam, the Netherlands. Abstract S877.

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    • Export Citation
  • 7.

    DiNardo CD, Stein AS, Stein EM, et al.. Mutant IDH1 inhibitor ivosidenib (AG-120) in combination with azacitidine for newly diagnosed acute myeloid leukemia [abstract]. Presented at 2019 SOHO Annual Meeting; September 11–14, 2019; Houston, Texas. Abstract AML-197.

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    • Search Google Scholar
    • Export Citation
  • 8.

    Cortes JE, Heidel FH, Hellmann A, et al.. Randomized comparison of low dose cytarabine with or without glasdegib in patients with newly diagnosed acute myeloid leukemia or high-risk myelodysplastic syndrome. Leukemia 2019;33:379389.

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    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Wei AH, Strickland SA Jr, Hou JZ, et al.. Venetoclax combined with low-dose cytarabine for previously untreated patients with acute myeloid leukemia: results from a phase Ib/II study. J Clin Oncol 2019;37:12771284.

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    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Pollyea DA, Pratz K, Jones BA, et al.. Venetoclax in combination with hypomethylating agents induces rapid, deep, and durable responses in patients with AML ineligible for intensive therapy. Presented at the 60th Annual ASH Meeting; December 1–4, 2018; San Diego, California. Abstract 285.

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