VIALE-A was a randomized (2:1), double-blind, placebo-controlled, multicenter, phase 3 clinical trial that evaluated the efficacy and safety of VEN+AZA vs placebo (PBO)+AZA in newly diagnosed patients with AML who were ≥75 years of age, or had comorbidities that precluded the use of intensive induction chemotherapy.
Complete remission (CR) was defined as absolute neutrophil count (ANC) >1,000/microliter, platelets >100,000/microliter, RBC transfusion independence, and bone marrow with <5% blasts. Absence of circulating blasts and blasts with Auer rods; absence of extramedullary disease.
Complete remission with partial hematologic recovery (CRh) was defined as <5% of blasts in the bone marrow, no evidence of disease, and partial recovery of peripheral blood counts (platelets >50,000/microliter and ANC >500/microliter).
| 76 | MEDIAN AGE |
| ~45% | ECOG 2-3 |
| 100% | INTERMEDIATE OR POOR CYTOGENETIC RISK |
| Baseline characteristics1 | ||
|---|---|---|
| Characteristic | VEN+AZA (N=286) | AZA (N=145) |
| Age, years; median (range) | 76 (49, 91) | 76 (60, 90) |
| Race, % | ||
| White | 76 | 75 |
| Black or African American | 1 | 1.4 |
| Asian | 23 | 23 |
| Male, % | 60 | 60 |
| ECOG performance status, % | ||
| 0-1 | 55 | 56 |
| 2 | 40 | 41 |
| 3 | 5.6 | 3.4 |
| Bone marrow blast, % | ||
| <30% | 30 | 28 |
| ≥30% to <50% | 21 | 23 |
| ≥50% | 49 | 49 |
| Disease history, % | ||
| De novo AML | 75 | 76 |
| Secondary AML | 25 | 24 |
| Cytogenetic risk detected,* % | ||
| Intermediate | 64 | 61 |
| Poor | 36 | 39 |
| Mutation analyses detected, n/N† (%) | ||
| IDH1 or IDH2 | 61/245 (25) | 28/127 (22) |
| IDH1 | 23/245 (9.4) | 11/127 (8.7) |
| IDH2 | 40/245 (16) | 18/127 (14) |
| FLT3 | 29/206 (14) | 22/108 (20) |
| NPM1 | 27/163 (17) | 17/86 (20) |
| TP53 | 38/163 (23) | 14/86 (16) |
*Cytogenetic risk grading from VIALE-A trial per the 2016 NCCN Guidelines®.
†Number of evaluable bone marrow aspirate (BMA) specimens received at baseline.
AML=acute myeloid leukemia; AZA=azacitidine; CLcr=creatinine clearance; CRh=complete remission with partial hematologic recovery; ECOG=Eastern Cooperative Oncology Group; FLT=fms-like tyrosine kinase; IDH=isocitrate dehydrogenase; NCCN=National Comprehensive Cancer Network; NPM1=nucleophosmin 1; OS=overall survival; PBO=placebo; TP53=tumor protein 53; VEN=VENCLEXTA.
Study M14-358 was a non-randomized, open-label trial that evaluated the efficacy and safety of VENCLEXTA (venetoclax tablets) in combination with azacitidine (VEN+AZA; N=84) or decitabine (VEN+DEC; N=31) in patients with newly diagnosed acute myeloid leukemia (AML).
Of those patients, 67 who received AZA combination and 13 who received DEC combination were 75 years or older, or had comorbidities that precluded the use of intensive induction chemotherapy based on at least one of the following criteria:
The median age of patients treated with VEN+DEC was 75 years (range: 68-86 years). ECOG performance status at baseline was 0-1 for 92% of patients and 2 for 7.7% of patients.
Of the 13 patients in the VEN+DEC arm, those who had mutations identified were as follows:
Intermediate or poor cytogenetic risk was present in 38% and 62% of patients, respectively.
DEC=decitabine; TLS=tumor lysis syndrome.
The efficacy and safety of VENCLEXTA (venetoclax tablets) in combination with low-dose cytarabine (VEN+LDAC; N=143) vs placebo with low-dose cytarabine (PBO+LDAC; N=68) were evaluated in VIALE C, a double-blind, randomized trial in patients with newly diagnosed AML.
At baseline, patients were ≥75 years of age, or had comorbidities that precluded the use of intensive induction chemotherapy based on at least one of the following criteria:
The median age of patients treated with VEN+LDAC was 76 years (range: 36-93 years). ECOG performance status at baseline was 0-1 for 52% of patients, 2 for 44% of patients, and 3 for 4.2% of patients.
Mutations identified were as follows:
Intermediate or poor cytogenetic risk was present in 63% and 33% of patients, respectively.
The median age of patients treated with LDAC was 76 years (range: 41-88 years). ECOG performance status at baseline was 0-1 for 50% of patients, 2 for 37% of patients, and 3 for 13% of patients.
Mutations identified were as follows:
Intermediate or poor cytogenetic risk was present in 63% and 29% of patients, respectively.
LDAC=low-dose cytarabine.
US-VENA-250092
VENCLEXTA® and its design are registered trademarks of AbbVie Inc.
VENCLEXTA Prescribing Information.
VENCLEXTA Prescribing Information.
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Acute Myeloid Leukemia V.3.2026. © National Comprehensive Cancer Network, Inc. 2026. All rights reserved. Accessed November 24, 2025. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Acute Myeloid Leukemia V.3.2026. © National Comprehensive Cancer Network, Inc. 2026. All rights reserved. Accessed November 24, 2025. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
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