["Only" has come] Optimize the AML diagnosis and treatment model, and explore the application of Vinekal in China

On June 4, 2021, the AbbVie AML Summit Forum was held online, with more than 4,200 online views
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Many hematology experts and scholars use the Internet as a department to talk about the frontiers of AML Chinese and foreign theories, think about the changes in the diagnosis and treatment of the era, and share "practical" experience to optimize the clinical application of Venecla in China, hoping that more standardized clinical management can help China AML patients bring more benefits
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The big coffee firm’s focus on the practice demonstration meeting of Vinecke was kicked off by Mr.
Osram, the general manager of AbbVie China.
After welcoming the experts, he said that since Vinecke went on sale in China, there have been three More than a thousand patients have used Venecla, which has accumulated valuable experience for wide clinical application
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In addition, he hopes that with the support of experts in the blood field, Venecla will be promoted into medical insurance as soon as possible to benefit the majority of patients
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Finally, on behalf of AbbVie, he pledged to support the academic development of China's blood industry in the long run
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Subsequently, the chairman of the conference gave speeches.
Professor Shen Zhixiang from Ruijin Hospital, Shanghai Jiaotong University School of Medicine stated that the listing of Venecla is a milestone in the field of AML.
In terms of clinical application, it is necessary to promote the incorporation of medical insurance and clinical practice verification as soon as possible, with definite curative effects.
The price of Hehuimin benefits more AML patients
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Professor Huang Xiaojun from the Institute of Hematology, Peking University pointed out that the emergence of Venecla plays an important role in the development of the AML field, and how to make good use of this "good weapon" is the most important thing
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Professor Ma Jun from the Harbin Institute of Hematology and Tumors also stated that Venecla has a promising future in the field of blood.
In view of its outstanding performance in unfit AML patients, it has been approved quickly in China and is ahead of Japan, Europe and other countries.
He hopes to start as soon as possible.
Real-world research in China facilitates clinical mastery of experience and serves patients
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Professor Liu Qifa from Nanfang Hospital of Southern Medical University also said that paying attention to the clinical practice of Venecla is extremely important for the clinical benefit of patients, and wished the conference a success
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China and foreign countries collide with Venecla to promote the changes in the era of AML.
The era of targeted therapy has come under the auspices of Professor Huang Xiaojun and Professor Ma Jun.
Professor Jin Jie from the First Affiliated Hospital of Zhejiang University The topic of "Evaluation and Rethinking" shared the changes in the evaluation criteria for AML "Fitness" patients at home and abroad
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In the era of strong induction chemotherapy, whether the patient can tolerate it is the main basis for choosing the first-line treatment for AML
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However, new types of targeted drugs represented by Venecla are gradually becoming available in the clinic, and options for the treatment of AML are increasing day by day, officially entering the era of targeted therapy
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With the rapid development of genome sequencing, molecular genetics has become an important basis for the prognostic stratification of AML patients
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Tolerability combined with prognostic factors, the important basis for AML treatment evaluation has changed from "Fitness" to "Eligible", that is, from "tolerable" to "suitable"
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In the current era of targeted therapy, the combination of gene mutation + Fitness assessment is the basis for first-line treatment selection for AML
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Moreover, Professor Jin Jie believes that with the continuous exploration of these new targeted drugs, the future treatment model of AML may be a comprehensive evaluation standard of patient characteristics + disease characteristics + Eligible evaluation + program efficacy evaluation.
Individualized treatment can promote AML.
The patient survives for a long time
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Led by "only", innovating AML diagnosis and treatment standards, and then Professor Wei Hui from the Institute of Hematology, Chinese Academy of Medical Sciences, interpreted the updated key points of the "AML China Diagnosis and Treatment Guidelines (2021 Edition)"
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He said that the new version of the guideline is still being improved.
At this stage, the new version of the guideline supplements IDH1/2 gene mutations in the primary examination, supplements and perfects the NPM1 mutation and FLT3-ITD mutation stratification in the prognostic group, and further reflects the molecular genetics.
Importance in the diagnosis and treatment of AML
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In terms of treatment, with the level of evidence of 2a, it is recommended that venecola combined with azacitidine or decitabine be used for patients 60-75 years old who have poor prognostic factors and are suitable for strong induction chemotherapy; 60-75 years old who are not suitable for standard-dose chemotherapy Patients and those who are >75 years old or have serious non-hematological comorbidities
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The new version of the guidelines even recommends venecola combined with azacitidine or decitabine as the treatment option for patients with CR after treatment with low-intensity induction chemotherapy with a level of evidence of 1a
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Professor Wei Hui also pointed out that the Chinese guidelines adopt RCT research evidence conducted by domestic researchers to guide domestic clinical treatment of Chinese patients, which is more in line with China's national conditions
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Laying the foundation with "V" and exploring the future.
Professor Shen Zhixiang and Professor Liu Kaiyan from Peking University People's Hospital chaired the "Era of the new standard of Care and beyond for AML patient ineligible to Intensive Chemotherapy" by Professor Andrew Wei of the Australian Leukemia and Lymphoma Research Group (ALLG) Thematic report session
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Professor Andrew Wei said that through the VIALE-A and VIALE-C studies, venecola combined with azacitidine or decitabine has become a new standard treatment for AML patients who are not suitable for strong induction chemotherapy or are ≥75 years of age.
The scope of application of the program may not stop there
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He also shared the management experience of tumor lysis syndrome (TLS) prevention and hematological adverse reaction (AE) through cases and his own experience
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At the same time, he also pointed out that it is worthy of in-depth exploration in terms of the timing of drug withdrawal in drug-resistant patients, "targeting" NPM1 MRD, elderly and infirm patients, and improving the outcome of patients who have failed the Venecla combination therapy.
The announcement of these results will be further in the future.
Improve the clinical application of Venecla
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Subsequently, under the chair of Professor Shen Zhixiang and Professor Liu Kaiyan, Professor Andrew Wei, Professor Jin Jie, Professor Wei Hui, and Professor Shen Yang from Ruijin Hospital of Shanghai Jiaotong University School of Medicine Suitable for use in elderly patients with strong induction chemotherapy (such as core binding factor-related [CBF] AML), whether younger patients with AML who are suitable for conventional chemotherapy can use Venecla, the synergistic effect of different Veneclas combination regimens And the serious hematological AEs that occurred after treatment with Venecla and were not suitable for the treatment of transplant patients, which provided a reference for clinical use in China
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Keep improving Veneclax explores the standard use of AML clinical practice in China and maximizes the benefits of clinical patients.
Under the auspices of Professor Li Junmin, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Professor Wang Shaoyuan from Fujian Medical University Affiliated Union Hospital, and Professor Niu Ting from West China Hospital of Sichuan University, Nanfang Professor Zhang Yu from Nanfang Hospital of Medical University, Professor Wei Xudong from Henan Tumor Hospital, Professor Chen Suning from the First Affiliated Hospital of Soochow University, and Professor Duan Minghui from Peking Union Medical College Hospital respectively combined the best dose from Venecla, AE management, treatment course exploration and combined use of antibiotics.
The fungal drugs were shared, and the clinical practice management of Venecla was discussed
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[Optimal dose] Professor Zhang Yu said that after a number of studies and repeated verifications, the optimal dose of Veneclax combined with demethylation drugs for the treatment of AML is 400 mg
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Compared with other doses, this dose has the best remission rate, remission duration and overall survival, and it is safe and tolerable
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Age, weight, ethnicity, and renal function have no effect on the apparent clearance of venacola, so these patients do not need to adjust the dose, but patients with severe liver damage are recommended to reduce the dose by 50%
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As for how to monitor the blood concentration of Venecla, Professor Zhang Yu said that there are not enough data standards yet, and further exploration is needed
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【AE Management】Professor Wei Xudong said that the AE of Venecla combined with azacitidine is predictable and manageable
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Hematology AEs are the main ones, which are generally more obvious in the first cycle, but as the treatment cycle is prolonged, the blood picture gradually recovers and the duration is shortened
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For patients who have not obtained CR, it is not recommended to adjust the dose or course of treatment, and should continue to use to achieve remission
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For patients who have obtained CR, if they have ≥4 grade hematological adverse reactions, and the recovery time exceeds 14 days, consider shortening the number of days of treatment with Veneclax to 21 days
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Professor Wei Xudong also shared the real-world data of Henan Cancer Hospital.
Similar to the clinical trial data, Venecla showed good efficacy and safety
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【Treatment exploration】Professor Chen Suning said that patients who have achieved remission should continue to be treated until the disease progresses or intolerable toxicity occurs
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Even for patients with CR, continued treatment can significantly reduce the risk of recurrence and prolong survival
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As for patients with minimal residual disease (MRD) negative, there is currently no evidence to support the discontinuation of Venecla
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Professor Chen Suning also pointed out that the VIALE-M study is exploring the effect of venecola combined with azacitidine in maintenance therapy for AML patients who have achieved remission for the first time after conventional chemotherapy, and the results are promising
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And he also believes that the long-term treatment model of Venecla will be further optimized
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【Combination of Antifungal Drugs】Professor Duan Minghui also discussed the related issues of the combined use of antifungal drugs during the treatment with Vinekalla
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He first pointed out that the risk of fungal infection during Venecla treatment is lower than that of traditional chemotherapy, so the prevention strategy is different from traditional chemotherapy, and newly diagnosed AML patients may not need antifungal prophylaxis
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For patients who need azole antifungal drugs for prevention, it is recommended to complete the dose increase of Veneclax, and then directly reduce the dose in combination with azole drugs; after stopping the azole, it is recommended to adjust the vitamin after a washout period of 2-3 days Nakala dosage
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If fungal infections occur, non-azoles can be considered when choosing antifungal drugs
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In the discussion session, Professor Li Junmin, Professor Wang Shaoyuan, Professor Niu Ting, Professor Zhang Yu, Professor Wei Xudong, Professor Chen Suning and Professor Duan Minghui adopted evidence-based practice, through research data, clinical practice and personal cases, the choice of dosage and blood drug concentration Venecla’s clinical management issues such as changes and monitoring, treatment options after myelosuppression, and the impact on infections have been answered
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Summary This meeting was finally summarized by Professor Liu Qifa.
He said that this meeting not only discussed the progress of AML treatment from the latest foreign developments to the current domestic research status, but also focused on the "star drug" for AML treatment-Wei The clinical application of Necla, how to use it well, and how to make it more widely applicable to AML patients is a "compulsory course" for every doctor in the field of blood
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Optimizing management and emphasizing practice can truly reflect the curative effect of Venecladine.
In the future, coupled with the popularization of medical insurance, I believe that Venecladine can make great progress in the field of blood! Click "Read the original text" below to view the highlights of the conference.
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This [article/share] is supported by AbbVie, and the specific content is independently produced, reviewed and published by Yimaitong
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