|The following article features coverage from the 2021 Annual Meeting of the Society of Hematologic Oncology (SOHO). Click here to read more of Hematology Advisor‘s conference coverage.|
The combination of azacitidine and venetoclax is associated with higher responses overall among patients with ASXL-1 somatic mutation higher-risk myelodysplastic syndromes (MDS) compared with azacitidine alone, according to study results presented at the Annual Meeting of the Society of Hematologic Oncology (SOHO).
A total of 35 patients (mean age, 67.8 years; 71% male; 97% White) received azacitidine/venetoclax for intermediate or higher-risk MDS, and 1127 similar-risk MDS patients (mean age, 68.4 years; 66% male; 90% White) received azacitidine upfront therapy alone.
The median follow-up was 15 months in the azacitidine/venetoclax group and 93 months in the azacitidine alone group. No differences were observed regarding baseline demographic or disease characteristics in the 2 groups, except higher rates of ASXL-1 and N-RAS somatic mutations occurred in the azacitidine/venetoclax group.
The median overall survival (OS) was 20 months for both groups. The complete response (CR)/marrow CR (mCR) rate was 71% in the azacitidine/venetoclax group (31%/40%), compared with 25% in the azacitidine group (13%/12%) (P <.005). For patients with an ASXL-1 somatic mutation, the CR rate was 47% in the azacitidine/venetoclax group and 9% in the azacitidine group (P <.005).
A higher proportion of patients who received azacitidine/venetoclax subsequently had allogeneic hematopoietic stem cell transplant (AHSCT) compared with those in the azacitidine group (40% vs 23%, respectively; P =.04). The median OS for participants who received azacitidine/venetoclax followed by AHSCT was not achieved vs 31 months for those who received azacitidine alone followed by AHSCT (P =.17).
Among patients who had AHSCT, the 2-year survival rate was 90% for the azacitidine/venetoclax group and 51% for the azacitidine group. “Early data are encouraging for azacitidine/venetoclax as a bridge to AHSCT,” the investigators stated.
Read more of Hematology Advisor’s coverage of SOHO 2021 by visiting the conference page.
Al Ali N, Sallman D, Chan O, et al. Azacitidine and venetoclax combination for upfront treatment of higher-risk myelodysplastic syndromes. Paper presented at: SOHO 2021 Virtual Annual Meeting; September 8-11, 2021; Abstract MDS-128.