Less-intensive combo improves AML outcomes in new trial

A less-intensive drug combination significantly delayed disease progression or death in newly diagnosed acute myeloid leukemia patients compared to standard intensive chemotherapy, according to a new clinical trial. The findings may alter initial treatment approaches for the disease. The phase 2 PARADIGM trial randomly assigned 172 adults to either azacitidine plus venetoclax or intensive chemotherapy. Patients on the combination went 14.5 months before treatment failure or death, versus 6.2 months for the chemotherapy group, with remission rates of 78% and 53%, respectively. The gentler regimen also caused fewer serious infections and bleeding, reduced initial hospital stays to 12.5 days from 27.3, and allowed more patients to proceed to stem cell transplantation. The trial was not designed to measure overall survival, and future studies should examine excluded patient subgroups.