VIDEO: Maintenance therapy promising in AML
In this video, Healio spoke with Farhad Ravandi, MD, about the promise of maintenance therapy in AML, which was discussed at the Society of Hematologic Oncology Annual Meeting.
Although maintenance therapy has been used in hematologic cancers for several decades in other diseases, such as myeloma, a lack of effective and relatively nontoxic agents stalled its use in AML. However, Ravandi said that new data have shown, for the first time, that maintenance therapy may be feasible in patients with AML.
Ravandi, professor of medicine and chief of the section of acute myeloid leukemia in the department of leukemia at the University of Texas MD Anderson Cancer Center, also discussed the large, multicenter, international study that led to the FDA approval of oral azacitidine tablets (Onureg; Bristol Myers Squibb) as a maintenance treatment in AML. The trial, which was conducted over approximately 4 to 5 years, represented an important step forward in investigation of maintenance therapy for AML, according to Ravandi.
“We have not been able to conduct a very large study in this setting because you first have to get the patients into complete remission and then introduce a drug and follow the patients for a long time before they relapse or die from complications,” Ravandi said, noting that a number of previous attempts at randomized studies on maintenance therapy in AML were not successful in accruing the right number of patients and doing the necessary follow-up. Additionally, many were terminated because the treatment was not well-tolerated.
With the successful completion —and positive results — of the study on oral azacitidine, Ravandi said researchers and clinicians are encouraged by the prospect of maintenance therapy in AML. Moreover, the availability of other treatments, such as venetoclax (Venclexta; Abbvie, Genentech) as well as targeted agents such as gilteritinib (Xospata; Astellas) for FLT3-mutated AML and ivosidenib (Tibsovo; Servier Pharmaceuticals) for IDH1-mutated AML, leaves the door open to further study of potential maintenance therapies in AML.
“With this, we may see a period where we rely more and more on using maintenance therapy in AML until we actually develop such really effective frontline strategies that would eradicate all leukemia,” Ravandi said.
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Healio Interview
