Combination Therapies in AML Treatment Approach

EP: 1.Overview of Pathophysiology of and Progression of AML

EP: 2.Risk Classification Systems in AML

EP: 3.Key Patient Factors to Consider in AML Treatment Decisions

EP: 4.Provider Perspectives on Biggest Unmet Needs in AML Care

EP: 5.Social Determinants to AML Treatment Approach

EP: 6.Latest NCCN Guidelines on the Standard of Care for Patients With AML

EP: 7.Patient Eligibility for Transplant, Induction, and Consolidation in AML Treatment

EP: 8.Venetoclax and the Impact on Management of Older Patients With AML

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EP: 9.Combination Therapies in AML Treatment Approach

EP: 10.Tracking the Shifting Treatment Landscape of AML

Patients with acute myeloid leukemia (AML) have access to increasingly sophisticated combination therapies that improve both survival and quality of life compared with historical single-agent treatments. The landmark VIALE-A and VIALE-C trials demonstrated that adding venetoclax to hypomethylating agents significantly improves outcomes for older patients, establishing this combination as standard care with median survival improvements of 5 to 6 months compared with hypomethylating agents alone. These studies were particularly important because they provided the first definitive evidence that combination therapy improved survival in patients previously relegated to palliative care approaches.

The success of venetoclax combinations has sparked extensive research into triple-drug regimens and additional targeted therapy combinations. Patients with specific genetic mutations may benefit from adding IDH inhibitors, FLT3 inhibitors, or other targeted agents to the backbone of hypomethylating agents and venetoclax. However, health care teams must carefully balance the potential benefits of more complex regimens against increased toxicity risks, particularly in older patients who may be more vulnerable to treatment-related complications.

Treatment selection increasingly depends on individual patient genetic profiles and tolerance for different adverse effect patterns. Patients with certain mutations may benefit from specific drug combinations, while those with others might do better with sequential rather than simultaneous therapy approaches. The evolving understanding of optimal combination strategies means that patients today have access to more personalized treatment plans but also require care at specialized centers capable of managing complex drug interactions, monitoring requirements, and supportive care needs associated with multiagent regimens.