Paradigm-changing outcomes for patients with acute myeloid leukaemia

Pharma News: Australian researchers have found a new combination treatment to treat a form of leukaemia that prolongs remission.

A new combination of AbbVie’s Venclexta (venetoclax) and low-dose chemotherapy is helping patients with acute myeloid leukaemia (AML) live longer.

Despite optimal treatment, many patients with AML have recurrent disease within the first two years. The measurable residual disease (MRD) test provides advanced warning that the disease is returning several months before the leukaemia is visible under the microscope or the patient develops abnormal blood counts.

As soon as MRD was detected to rise, patients were treated with the combination therapy.

Dr Ing-Soo Tiong, haematologist and researcher at Peter Mac, said with the previous approach to treatment, the median survival after first relapse is only 6-8 months. Results of this clinical trial shows 50-70% of AML patients are still alive after two years.

“Prior to this discovery, patients and clinicians face the uncertainty of disease relapse, and the only treatment option then was an even stronger dose of salvage chemotherapy requiring at least a month of stay in hospital associated with a very high risk of infection,” he said.

“In this new study we measured a patient’s MRD as soon as they finished chemotherapy with the aim of the data telling us which patients were most likely to relapse.”

Professor Andrew Wei, co-lead of the AML program at Peter Mac and Royal Melbourne Hospital, explained this option meant patients could be treated as an outpatient or by hospital in the home with results comparable to intensive chemotherapy.

“This is a paradigm-changing clinical trial that utilises molecular technologies to enable patients to receive their interventional therapy much earlier than normal and with less toxicity,” he said.

He further added, “The response to treatment was fast and durable, enabling patients to receive a subsequent stem cell transplant with much lower levels of disease burden and enhanced fitness.

“This is the first ever prospective trial using a pre-emptive MRD targeted approach. It has led to the development of a new national trial called INTERCEPT, coordinated by the Australasian Leukaemia and Lymphoma Group.”

The INTERCEPT trial is currently recruiting patients at Peter Mac and approximately 15 sites nationwide.

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