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ASH 2024 | Association between BMI and outcomes for patients with AML treated with HMA plus venetoclax
Rory Shallis, MD, Yale Cancer Center, West Haven, CT, comments on the association between body mass index (BMI) and outcomes in patients with newly diagnosed acute myeloid leukemia (AML) treated with hypomethylating agents (HMA) and venetoclax. He states that a large consortium analysis of over 350 patients found no statistically significant differences in early mortality, complete remission, or median overall survival across BMI categories. Dr Shallis notes that while numerically, patients with a BMI greater than 30 trended worse, the results suggest that BMI has no impact on treatment outcomes in this patient population. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI-generated)
Certainly, this is another poster that was presented by who’s now a fellow at Duke and I’ve been mentoring, this is Dr Julian Weiss. And this is another COMMAND consortium analysis. I believe this is a little over 350 patients. We tried to answer the question, does baseline, within 30 days I think was our kind of requisite sort of analysis, impact the responses and outcomes of patients treated with azacitidine, or sorry, HMA-venetoclax...
Certainly, this is another poster that was presented by who’s now a fellow at Duke and I’ve been mentoring, this is Dr Julian Weiss. And this is another COMMAND consortium analysis. I believe this is a little over 350 patients. We tried to answer the question, does baseline, within 30 days I think was our kind of requisite sort of analysis, impact the responses and outcomes of patients treated with azacitidine, or sorry, HMA-venetoclax. Knowing that standard venetoclax dosing, which is now a reference standard for less intensive treatment for AML, is its flat dose. And venetoclax, you know, there’s enough evidence to suggest it does have a wide volume distribution, pretty lipophilic. So there are some patients that might have variants in their BMI, and this could lead to maybe differences in peak levels or drug exposure. So in evaluating different, I believe it was tertiles, we looked at, not tertiles, but patients that had BMI less than 25, but I think we capped it above 18, just so we didn’t include a lot of the, you know, maybe patients who were burdened by malnourishment or anorexia, and then up to 30 plus, which was our third sort of group of patients that would be characterized as being quite obese. And we found no differences, at least statistically significant differences, in the rate of early mortality, even though numerically it did trend worse for those patients with a BMI of greater than 30 plus. We found no differences in the rate of true CR or composite remission, in this case defined as CR/CRI, and no clear differences in the rate of, or no differences in median overall survival, ranging from 18 to 15 months, depending on these three subgroups. So in essence, we think that this study really demonstrated, I think it’s the largest study to date evaluating this question, that it has no impact. BMI has no impact on patients getting ven or not.
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Disclosures
Kura Oncology: Consultancy, Honoraria; Rigel: Consultancy, Honoraria; Servier: Consultancy, Honoraria, Other: Steering Commitee; Gilead Sciences, Inc: Consultancy, Honoraria.
