Data from Investigational Clinical Trial Agents versus Conventional Second Salvage Therapies in Patients with Relapsed/Refractory Acute Myeloid Leukemia
Year: 2026
Type: other
Abstract: Purpose: Outcomes in patients with relapsed/refractory (R/R) acute myeloid leukemia (AML) remain discouraging despite the rapid expansion of treatment paradigms over the past decade. Clinicians must often decide between conventional salvage treatment regimens or enrollment in clinical trials. Experimental Design: We retrospectively identified 657 patients with AML in second treatment salvage and compared the outcomes of those who received investigational agents (n = 354) with conventional salvage regimens (n = 303). Results: Conventional salvage was associated with higher response rates [complete response (CR) or CR with incomplete count recovery rate: 22% vs. 12%, P = 0.0008] and higher early mortality rates (60-day mortality: 17% vs. 7%, P = 0.0002). There was no difference in rates of bridging to allogeneic stem cell transplant (7% vs. 10%, P = 0.2), event-free survival (EFS; median: 1.5 vs. 2 months, P = 0.9), or overall survival (OS; median: 4.1 vs. 4.5 months, P = 0.8). A subgroup analysis of conventional regimens showed improved EFS (median EFS: 3.6 vs. 1.4 months, P = 0.004) and a trend toward improved OS (median OS: 7.5 vs. 3.8 months, P = 0.06) with the addition of venetoclax in venetoclax-naïve patients. Conclusions: Enrollment of R/R patients in clinical trials is a suitable alternative to conventional salvage regimens, offering novel therapeutic approaches to improve upon the historically dismal outcomes in this setting.
Authors: Daniel Nguyen, Hagop M. Kantarjian, Aram Bidikian, Christopher M. Manuel, Wei Qiao, Jing Ning, Courtney D. DiNardo, Tapan M. Kadia, Naval Daver, Gautam Borthakur, Elias Jabbour, Musa Yilmaz, Abhishek Maiti, Koji Sasaki, Guillermo Montalban-Bravo, Kelly Chien, Danielle Hammond, Sherry Pierce, Michael Andreeff, Farhad Ravandi, Nicholas J. Short, Guillermo Garcia-Manero, Ghayas C. Issa
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W7213228303
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