Maintenance Therapy for Patients With AML

This is a synopsis of an Insights series featuring Catherine E. Lai, MD, MPH, of the University of Pennsylvania.

For AML patients not proceeding to transplant after consolidation chemotherapy, Dr. Catherine E. Lai discussed the FDA-approved oral maintenance regimen of azacitidine, which improves overall and leukemia-free survival, particularly in NPM1-mutated patients. Recent data also shows oral azacitidine maintenance extends time to first subsequent therapy at relapse versus placebo.

Dr. Lai highlighted important azacitidine maintenance data presented at the 2023 ASH meeting. A retrospective study compared oral azacitidine after intensive chemotherapy to azacitidine/venetoclax, showing benefit for the oral azacitidine maintenance patients who received it post-intensive chemotherapy. Another study found improved relapse-free survival with oral azacitidine irrespective of baseline mutations prior to starting maintenance versus placebo.

For FLT3-ITD mutated patients, Dr. Lai discussed the FDA-approved quizartinib, which is continued through consolidation and maintenance after initial 7+3 chemotherapy. Quizartinib maintenance improves overall survival. ASH data showed no detriment to quality of life with quizartinib versus improved survival. An oral abstract demonstrated quizartinib also enhances minimal residual disease (MRD) negativity, deepening remission.

In summary, Dr. Lai provided an overview of emerging maintenance approaches for AML patients not proceeding to transplant, particularly oral azacitidine for all molecular subtypes and quizartinib for FLT3-ITD mutations. Maintenance therapy is becoming increasingly important for preventing relapse and prolonging remissions without impacting quality of life. Data continue to evolve, but maintenance is likely to take on a larger role in the AML treatment paradigm.

*Video synopsis is AI-generated and reviewed by OncLive editorial staff.