Acute myeloid leukemia, new oral therapy available in Italy that reduces the risk of recurrence
[ad_1]
The first ‘attack’ on the disease is crucial because everything else depends on how the body responds, but maintenance therapy is also very important. It applies to all neoplasms and among these acute myeloid leukemia, a blood cancer that affects about 3600 people in Italy. But in 50% of cases the disease returns within a year. Today there is one more possibility of keeping this risk at bay thanks to a new hypomethylating drug, oral azacitidine, which can improve survival by reducing the likelihood of recurrence. Indeed, the Italian Medicines Agency (AIFA) has approved its reimbursement as maintenance therapy. A press conference today in Rome, organized with the support of Bristol Myers Squibb, is dedicated to the new prospects for the treatment of acute myeloid leukemia.
Acute myeloid leukemia: Aifa approves new therapy that extends survival by 15 months
by Irma D’Aria
Symptoms of acute myeloid leukemia
Acute myeloid leukemia is a blood cancer that has the highest incidence in the over 65s. It is a particularly aggressive haematological disease, in fact the 5-year survival, depending on age, fluctuates between 20% and 40-45% and does not exceed 12 months for patients with relapsed or refractory disease. “The symptoms depend on the progressive infiltration of leukemia cells into the bone marrow, which loses the ability to perform its functions and produce blood cells – he explains Adriano Venditti, director of Hematology at the University of Rome Tor Vergata. A condition of bone marrow insufficiency occurs which leads to anemia, tiredness and pallor. The number of platelets decreases, with a tendency to haemorrhage. Furthermore, there is a reduction in white blood cells which determines a greater probability of developing infections, precisely because the defenses made up of white blood cells are lost. The alterations of the blood count values lead to the diagnosis, which also passes through the bone marrow sampling”.
Fear and uncertainty about remission
“It is one of the most insidious and difficult haematological diseases to treat, which often presents a subtle onset. “In many cases – he explains Marco Vignetti, vice-president of AIL (Italian association against leukemia, lymphoma and myeloma) – the patient passes in a short time from a state of well-being to a condition of serious impairment of the state of health. The emotional impact of a sudden diagnosis of acute myeloid leukemia is devastating for both patients and their families. The most common reaction is a sense of profound distress and concern, which subsides as complete remission is achieved. In patients in remission, however, uncertainty arises due to the possibility that the disease may recur. These elements underline the need to provide innovative therapies able to reduce the risk of recurrence and structured psychological support. Fragility and uncertainty, combined with anxiety, are the keywords that accompany the lives of patients and caregivers on a daily basis”.
Nicola Piovani and the experience of cancer transformed into music
by Tiziana Moriconi
The risk of recurrence
Unfortunately, responses to intensive chemotherapy can be short-lived and the risk of recurrence is high, especially for people ineligible for a stem cell transplant. With the reimbursement of the new hypomethylating drug, oral azacitidine, the standard of care may change. The Italian Medicines Agency has approved the reimbursement of oral azacitidine as maintenance therapy in patients who have achieved complete remission or complete remission with incomplete recovery of blood count after induction therapy with or without consolidation treatment and who do not are candidates for hematopoietic stem cell transplantation. “After the initial response, approximately 50% of cases recur within a year. Thanks to the approval of the reimbursability of oral azacitidine by AIFA, the horizon of treatment radically changes”, he declares Fabrizio BreadFull Professor of Hematology and Director of the Hematology and Bone Marrow Transplant Operational Unit at the Federico II University of Naples.
The Karnofsky Award to Hagop Kantarjian, who made leukemia curable
by Daniele Banfi
The mechanism of action
Azacitidine is the first and only oral maintenance therapy that has been shown to increase overall survival and has shown a recurrence-free survival benefit in patients with acute myeloid leukemia. “The drug falls into the class of hypomethylants, because it reduces DNA methylation: in this way the normal function of the genes fundamental in cell differentiation and proliferation compromised by the disease is restored – he says Bread. In the international study QUAZAR AML-001, published in the ‘New England Journal of Medicine’, which enrolled 472 patients, the median overall survival was greater than two years (24.7 months) in patients treated with oral azacitidine compared to 14.8 months on placebo. Median recurrence-free survival was also significantly longer with oral azacitidine and reached 10.2 months compared to 4.8 months in the control arm.
How important is maintenance therapy?
The availability of innovative therapies such as oral azacitidine reopens the ‘chapter’ of maintenance therapy, for which interest had waned for at least twenty years. “With oral azacitidine – underlines Venditti – maintenance therapy begins to play an important role again, not only for elderly patients. Younger people should also be considered, in whom eligibility for standard intensive chemotherapy does not necessarily imply eligibility for subsequent stem cell transplantation. The general conditions of the patient must then be analysed, who, during intensive chemotherapy, may develop complications that contraindicate allogeneic transplantation. In fact, it is estimated that only 20-30% of patients eligible for a transplant are then able to actually access this complex procedure. There is therefore a large number of patients who, regardless of age, can find benefit from oral azacitidine”.
[ad_2]
Source link
