Venetoclax in AML: aiming for 'just right'

摘要

In this issue of Blood, DiNardo and colleagues present much-awaited early phase data on the safety and efficacy of using the B-cell lymphoma 2 (BCL-2) inhibitor venetoclax in combination with hypomethylating agents to induce older individuals with acute myeloid leukemia (AML). 1 Remission induction in older or less fit individuals has long required providers, and their patients, to choose between therapies deemed either reasonably effective but toxic ("too hot") or safe but weak ("too cold"). Since early hints of venetoclax activity in AML were first aired, hopes have been building that there might be a middle ground, a "just right" way to induce the typical patient with AML, who is older and may have comorbidities. This well-conducted, multicenter, phase 1b trial, which enrolled 145 subjects 64 years of age and deemed unsuitable for intensive induction, certainly bolsters such hopes, although a few lumps in the porridge should be considered as one digests these data.