ASH 2023 | Improving long-term outcomes with intensive chemotherapy in AML: looking to the future

So I was asked to give a presentation at one of the AML education sessions at this year’s ASH. And what I did was to kind of give a quick journey from the past to the present and the future of intensive chemotherapy. So the regimen we use as a backbone for intensively treatable patients, 7+3, had its anniversary this year, so it was published 50 years ago, and we still use it. And I was trying to show why it is still relevant, because with intensive chemotherapy, that’s how we cure patients. Long-term remissions are only possible at this point with intensive chemotherapy, we have the highest evidence on that. And I explained to the audience potential modifications of 7+3 by using, novel agents such as gemtuzumab ozogamicin/midostaurin in addition to chemotherapy or using CPX351 instead of intensive chemotherapy, instead of 7+3. 

In the second part of my presentation, I talked about novel developments on new data on novel targeted agents, such as quizartinib, that has just recently been approved for the use in combination with intensive chemotherapy for newly diagnosed fit patients with FLT3-ITD mutation. And in the end, I try to give the audience a future perspective on where we are going with intensive chemotherapy. So there are two main directions. One is how does the efficacy of intensive chemotherapy relate to the efficacy of venetoclax and azacitidine? So there are comparative randomized studies ongoing that are very interesting. And on the other hand, if we assume that intensive chemotherapy will stay around for some more years, then the combination of this intensive chemotherapy backbone with novel agents, that is also explored in several randomized trials, is the way to go in the future.