ASH 2024 | Impact of high-risk mutations on outcomes of patients with AML receiving CPX-351 induction
Fabio Guolo, MD, University of Genoa, Genoa, Italy, discusses the impact of high-risk gene mutations on the response to CPX-351 induction in patients with acute myeloid leukemia (AML). Dr Guolo notes that despite critical genes being assessed, none of the single gene mutations or combinations of gene mutations significantly affected complete response (CR) rates or measurable residual disease (MRD) clearance, suggesting that CPX-351 is active across various mutations. While this finding is positive, as it indicates the efficacy of this therapeutic approach across different genetic profiles, it is also negative, as it hinders the ability to predict which patients will not respond to the treatment. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI-generated)
We know that gene mutations are a key prognostic factor in AML patients, but most of the information comes from older treatment approaches, such as 3+7 and similar. We do not still know how newer approaches impact those mutations, so we looked at patients who received CPX-351 induction and we checked in a panel of 34 critical myeloid genes for mutation to see if some of them had an impact on response to CPX...
We know that gene mutations are a key prognostic factor in AML patients, but most of the information comes from older treatment approaches, such as 3+7 and similar. We do not still know how newer approaches impact those mutations, so we looked at patients who received CPX-351 induction and we checked in a panel of 34 critical myeloid genes for mutation to see if some of them had an impact on response to CPX.
What we found is that none of the single gene mutations or combinations of gene mutations impacted in terms of CR rate or minimal residual disease clearance, so we couldn’t find any positive or negative predictor of response, which on one side is good because the drug is active in all the mutations. On the other side we cannot predict why a patient would fail to respond to the drug, so we have both good and bad news. And then we tried to compare with known genes that predict lack of response to hypomethylating agents and venetoclax. And we observed that in a CPX-treated patient there is no impact from those mutations.
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