For older patients with acute myeloid leukemia (AML), the outlook is poor: very few achieve remission and for patients who don’t the option is mostly palliative.
However, a new drug trial in Australia has achieved an incredible result, clearing leukemia from bone marrow in close to 60% of patients. The trial was considered so effective that the FDA approved its use in November 2018 for the treatment of AML.
Kaye Oliver, 74, was the first patient in the world enrolled in the trial in 2015, the results of which have just been published in the Journal of Clinical Oncology. At diagnosis, there was little hope of Oliver’s survival beyond a few months, but four years later she remains well and shows no evidence of the cancer.
According to researchers, combining low-dose cytarabine with venetoclax in older patients led to a 54% response rate, with half of the study population surviving for longer than 10 months. Separately, the drugs have little effect: in a U.S. trial, taking venetoclax alone led to a 19% response rate and cytarabine alone produced a similar result.
The current research is supported by another trial in older patients with AML, which combined venetoclax with azacytidine and led to a 71% remission rate, and an average life expectancy of almost 17 months.
The drug combination acts on BCL-2, a protein in leukaemia cells which controls their survival. Venetoclax acts by switching off the protein and activating a self-destruct program in the cell.
In addition to the treatment’s success, the findings are important because AML is likely to increase in the future as the population ages. The researchers say that over the next three decades, the number of people over the age of 65 who develop AML is expected to double, making the search for more effective treatments vital.
Source: EurekAlert!, March 20, 2019