SOHO 2025 | Insights into the VINCENT trial: venetoclax + azacitidine versus intensive chemotherapy in NPM1m AML

The VINCENT trial is a very interesting trial addressing a burning question that is currently discussed in the hematology community and the question is whether the powerful combination of azacitidine and venetoclax even in fit patients may be sufficient to induce remission and allow patient long-term survival as opposed to intensive chemotherapy that is the standard of care which achieves high remission rates but is also accompanied by a lot of toxicity and hospital inpatient stays. So in a particularly receptive or responsive subgroup of AML that is AML with NPM1 mutations, venetoclax and azacitidine work very well in terms of remission and also long-term response and also long-term remission and in this subgroup of fit patients with NPM1 mutation we do a randomized comparison in the Vincent study comparing aza-ven versus standard of care which is 7 plus 3 plus gemtuzumab ozogamicin and apart from classical remission and survival endpoints we also look at MRD because in NPM1 positive disease that is a very good surrogate marker for response and prognosis and in that way we get results early and also avoid under treatment of those patients. So the Vincent study has a kind of brother study in the UK called VICTOR and in VICTOR the same comparison is made but with venetoclax combined with low-dose cytarabine instead of azacitidine. Both trials are still recruiting and we are keen on looking at the results and to see whether this lower intensity regimen can actually be a valuable alternative for our patients with NPM1 mutations.

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