Oral Azacitidine May Increase Survival in Older Patients with AML

Renowned Oncologist Explains A new therapeutic strategy in AML therapy

• Oral azacitidine (brand name: ONUREG) improves disease-free survival in older adults with AML who are in complete remission following intensive chemotherapy
• This is the first time a maintenance therapy has shown a survival advantage in this age group
• However, Dr. Mikkael Sekeres says it may be difficult to convince older adults who have already undergone chemotherapy to do so again

Maintenance therapy with the oral version of azacitidine (brand name: ONUREG) significantly improves disease-free survival in older adults with acute myeloid leukemia (AML) who have achieved complete remission on intensive chemotherapy, according to research published in the journal Blood. This is the first time a maintenance therapy has shown a survival advantage in older adults, who make up the vast majority of AML patients.

There has not been an established post-remission treatment to prevent relapse in this group until now. “We’ve had a lot of exciting developments in the treatment of acute myeloid leukemia within the past few years,” Dr. Mikkael Sekeres, formerly of the Cleveland Clinic, who is now the chief of the Division of Hematology at Sylvester Comprehensive Cancer Center at the University of Miami, tells SurvivorNet Connect. “This does seem to be real. There is a survival advantage,” he says.

When interpreting overall survival, it is important to adjust for the fact that patients who received azacitidine and one or two cycles of induction chemotherapy were compared to patients who received only one cycle of induction chemotherapy and no azacitidine. Even so, azacitidine appears to offer an advantage, which is why Dr. Sekeres is recommending it for his older AML patients.

It can be difficult to convince an older adult who has already been through chemotherapy to face this treatment yet again. “Part of the way that I do this is introducing the topic while that patient is still hospitalized receiving induction chemotherapy,” Dr. Sekeres says.