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Will Novel Agents Benefit the Older AML Patient Population?

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Published on July 10, 2019

During this Ask the Expert segment, Dr. Daniel Pollyea, from the University of Colorado School of Medicine, discusses the course of care and quality of life for the older acute myeloid leukemia (AML) patient population. Are older AML patients good candidates for newer therapies? Watch now to learn more about treatment tolerability, side effects and outcomes with novel agents. 

This program is sponsored by AbbVie, Inc and Genentech, Inc. It is produced by Patient Power in partnership with The Leukemia & Lymphoma Society (LLS) and NeedyMeds. These organizations have no editorial control, and Patient Power is solely responsible for program content.

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Transcript | Will Novel Agents Benefit the Older AML Patient Population?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That's how you’ll get care that's most appropriate for you.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:

So, not everybody, but a lot of people who develop AML are older. And I had a cousin years ago, didn’t live long with what was available then. Are treatments changing for older people in what you’ve said, and they're sort of—I don’t want to say kinder, gentler, but maybe you're more frail when you're old, but even with this revolution can give older people, mom, dad, grandma, grandpa hope.

Dr. Pollyea:                 

You know, older people is really ground zero for AML. So, this standard of care for many years has been a newly diagnosed patient would receive intensive induction chemotherapy. Sometimes we call it the seven plus three regiment. People might…that might sound familiar to them. Now, that is the standard of care, but because like, you said, the average patient with AML is older, the standard of care can be very difficult to apply to older patients because older patients have a very difficult time with intensive chemotherapy.  

So, for the last several years, decade at least, the population of AML that's really been the most intensely studies with respect to drug development and new clinical trials has been older patients, newly diagnosed, who can't tolerate intensive induction chemotherapy. And so, in fact, most of these advances that I've spoken about, the new drugs approved in the last two years, et cetera, most of them are specific to older newly diagnosed patients. 

And so, yes, I would say the bulk of advances in drug development in the recent past have been for older AML patients because that's the bulk of who AML is. Yes, like you said, AML can happen in younger patients, but that's really rare. That's uncommon. This is mostly a disease of older patients.  

Andrew Schorr:          

Okay. One of the approaches has been, in blood cancers, generally, has been transplant, which is a big deal. Maybe not right for someone who's older. And so, now you have pills, as well. So, what kind of success are you seeing with these pills?

Dr. Pollyea:                 

Yeah, so a lot of these pills are dramatic. I mean, we have venetoclax (Venclexta) is the main one that comes to mind in terms of a newly diagnosed older AML patient, and just this past November, the FDA approved the use of venetoclax with a low intensity chemotherapy backbone treatment for this population, a newly diagnosed, older AML patient. 

Prior to this, the standard of care had been using just low intensity chemotherapy treatments and the responses and the outcomes there have been quite disappointing. The response rates that we see with venetoclax, which is the pill that you mentioned in this setting are really really promising, unlike anything we've really seen. The duration of responses are very good. The patient's quality of life is quite good. 

So, that's just one example. There are several other pills that play that are relevant here. Some are for patients in the relapse setting when they have particular gene mutations. We talked before that almost every patient has at least one if not several gene mutations. We've been able to target several of those gene mutations with pill therapies, and most of those have been approved in the relapse setting. 

So, relapsed AML patients, usually older can now be candidates for these pill therapies that can work quite well and have a very tolerable side effect profile for the most part if they carry a particular mutation; if their disease carries a particular mutation. So, that's a really promising new direction too. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.