A US study has found patients with acute myeloid leukaemia (AML) with IDH2 mutations respond well to a combination of chemotherapy and enasidenib (ENA).
The phase II study led by The University of Texas MD Anderson Cancer Center. It showed that combining azacitidine (AZA) with ENA, a small molecule inhibitor of mutant IDH2, yielded positive results for newly-diagnosed patients, with improved complete response and overall response rates compared to AZA alone.
Dr Courtney DiNardo recently presented the findings to delegates at the 61st American Society of Hematology Annual Meeting & Exposition in Orlando, Florida.
Between October 2016 and August 2018, 101 patients were randomised to receive either ENA plus AZA, or AZA alone. Overall response rates for patients receiving both drugs were 68%, compared with 42% for those receiving AZA alone.
Complete remissions were reported in 50% of the combination group compared to 12% in the AZA-only group. Grade 3-4 side effects from the combination therapy included low white blood cell count, low platelet count, anaemia, IDH differentiation syndrome and low-grade infections.
Dr DiNardo said: “These findings are significant, given that the older a patient is, the more likely they are to have an IDH2 mutation. This combination treatment may offer an alternative option for older patients who may not be candidates for intensive chemotherapy or who have relapsed disease.”
Source: Enasidenib Plus Azacitidine Significantly Improves Complete Remission and Overall Response Compared with Azacitidine Alone in Patients with Newly Diagnosed Acute Myeloid Leukemia (AML) with Isocitrate Dehydrogenase 2 (IDH2) Mutations: Interim Phase II Results from an Ongoing, Randomized Study. Abstract 643. ASH 9 December 2019