Acute myeloid leukaemia (AML) is the most common leukaemia in adults and accounts for about 80% of all cases. DA regimen is the  standard induction regimen for adult AML, consisting of daunorubicin and cytarabine, also known as the "3+7" regimen. Only 60–80% of patients with acute myeloid leukaemia achieve complete remission with the DA regimen and long-term (5-year) overall survival in adults is less than 50% in most clinical trials. Novel therapeutic regimens with higher complete remission rates and greater survival benefits are urgently needed.

In 2000, Professor JIN Jie’s team from the Department of Hematology of the First Affiliated Hospital of Zhejiang University (FAHZU) developed HAA regimen for AML patient, and showed that the remission rate was increased by 12% compared with the DA regimen, reaching a CR rate of 73%. In spite of that, nearly 30% of AML patients are still unable to obtain complete remission (CR). With the launch of BCL2 inhibitor venetoclax in China bring new hopes for AML patients, the treatment of AML is expected to achieve further breakthroughs.

On May 2nd 2022, Professor JIN Jie and Professor ZHU Hong-Hu’s team published an article entitled “Venetoclax plus 3 + 7 daunorubicin and cytarabine chemotherapy as first-line treatment for adults with acute myeloid leukaemia: a multicentre, single-arm, phase 2 trial” in Lancet Haematology (IF: 18.959). This study aimed to evaluate the efficacy and safety of veneclax combined with the "3+7" regimen (DAV regimen) in treatment-naive adult AML patients.

Fig 1.Swimmer plot of dynamic response assessment

Table 1: Response assessment.

This study is an important contribution to the field, showing a safe strategy to incorporate venetoclax into the most common induction regimen used to treat newly diagnosed acute myeloid leukaemia internationally. DAV regimen showed a high rate of complete remission and measurable residual disease-negativity, and might be considered as an optimal induction treatment in de novo acute myeloid leukaemia.

At the same time, the encouraging results of this phase 2 study will be further validated by the same group's ongoing randomized controlled trial comparing DAV and DA regimens in newly diagnosed adult AML patients (ChiCTR2100045780).

Prof. Kieran D Sahasrabudhe from The Ohio State University Comprehensive Cancer Center give the comments in the journal Lancet Haematology that “WANG Huafeng and colleagues report their findings from, to our knowledge, the first published phase 2 study of venetoclax combined with the 3+7 daunorubicin and cytarabine induction regimen. ” and “The study by Wang and colleagues shows favourable response rates, a high rate of measurable residual disease-negativity among patients with response favourable survival data, and manageable adverse effects with venetoclax plus 3 + 7 daunorubicin and cytarabine chemotherapy. ”

More information: Professor ZHU Hong-Hu is the corresponding author, and is also joint senior author with Professor JIN Jie. Dr. WANG Huangfeng is the lead first author, and Dr. MAO Liping, Dr. YANG Min, Dr. QIAN Pengxu and Dr. LU Huanare are co-first authors.

This study was supported by grants from the Key Research and Development Programme of Zhejiang (2022C03005 to H-HZ and 2021C03123 to JJ), grants from the Leading Innovative and Entrepreneur Team Introduction Programme of Zhejiang (2020R01006 and 2019R01001 to H-HZ), and grants from the National Natural Science Foundation of China (81820108004 and 82170144 to JJ).