ASH 2020 | Venetoclax prior to allo-HCT for high-risk myeloid malignancies

Jacqueline Garcia, MD, Dana-Farber Cancer Institute, Boston, MA, discusses the findings of a Phase I trial (NCT03613532) combining the BCL-2 inhibitor venetoclax with conditioning chemotherapy prior to allogenic hematopoietic cell transplantation (allo-HCT). The frequency of relapse following allo-HCT in high-risk acute myeloid leukemia (AML), myelodysplastic syndrome (MDS) or MDS/myeloproliferative neoplasm-unclassifiable warranted investigation of venetoclax plus fludarabine and busulfan reduced intensity conditioning chemotherapy to explore the possibility of increasing anti-leukemic efficacy. 76% of evaluable patients were in complete response (CR) at day +100, and the 12-month overall survival (OS) and progression-free survival (PFS) were 72% and 55% respectively. Addition of venetoclax at the highest tested dose of 400mg did not increase chemotherapy toxicity or the incidence of graft-versus-host disease, supporting further evaluation as a recommended Phase II dose. This interview took place during the 62nd American Society of Hematology (ASH) Annual Meeting and Exposition, 2020.