Early Real-World First-Line Treatment With Venetoclax Plus HMAs Versus HMA Monotherapy Among Patients With AML in a Predominately US Community Setting

Anda Gershon, Esprit Ma, Tao Xu, Melissa Montez, Kiran Naqvi, Grace Ku, Wendy Wei Han Cheng, Evelyn M. Flahavan, Vamsi Kota, Daniel R. Greenwald

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Venetoclax in combination with hypomethylating agents (HMAs) is standard-of-care in patients with newly diagnosed acute myeloid leukemia (AML) who are ≥ 75 years old or unfit for intensive chemotherapy. We examined early real-world treatment experience among patients with AML receiving venetoclax+HMAs or HMA monotherapy. Patients and methods: This retrospective cohort study used an electronic health record-derived, deidentified, United States nationwide database comprised of patient-level structured and unstructured data, curated via technology-enabled abstraction. Patients with an AML diagnosis on or after January 1, 2014, who had ≥ 2 clinic visits, and initiated treatment with venetoclax+HMAs from June 1, 2018 to March 31, 2021, or HMA monotherapy from January 1, 2016 to May 31, 2018, were included. Kaplan–Meier analysis was used to estimate time to last administration (TTLA) and overall survival (OS). Results: Overall, 619 patients treated with venetoclax+HMAs and 480 treated with HMA monotherapy were selected from the database. Median age at diagnosis was 76 and 78 years, respectively, most patients were treated in community practice (83.4% and 89.4%, respectively), and almost half had secondary AML (47.2% and 47.3%, respectively). Adjusted analyses showed both significantly longer TTLA (3.6 months vs. 2.3 months; hazard ratio [HR] = 0.69 [95% confidence interval (CI), 0.60-0.80], P< .0001) and OS (9.3 months vs. 5.9 months; HR = 0.71 [95% CI, 0.61-0.82], P < .0001) in patients treated with venetoclax+HMAs versus HMA monotherapy, respectively. Conclusion: This study shows benefit in real-world outcomes of venetoclax+HMAs relative to HMA monotherapy in patients with newly diagnosed AML, using a predominantly community-based database.

Original languageEnglish (US)
Pages (from-to)e222-e231
JournalClinical Lymphoma, Myeloma and Leukemia
Volume23
Issue number5
DOIs
StatePublished - May 2023

Keywords

  • Acute myeloid leukemia
  • Azacitidine
  • Decitabine
  • Outcomes research
  • Real-word data

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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