OnCo
ideasIdea

Shorter venetoclax courses in unfit AML

Give venetoclax for 7 or 14 days per cycle instead of 28 to cut infections and low blood counts without losing the benefit.

Cytopenias and infections are the main cause of early death on venetoclax-azacitidine. Retrospective and small prospective series show similar remission rates with 14-day or 7-day venetoclax after the first cycle.

Hypothesis
Venetoclax 14 days per 28-day cycle after cycle 1 is non-inferior to 28 days for OS in unfit AML and reduces grade 3+ infection.
Rationale
Marrow blasts clear within the first two weeks; continued exposure mainly suppresses normal haematopoiesis.
What would test it
Randomised non-inferiority trial of 14- vs 28-day venetoclax with azacitidine (or oral decitabine-cedazuridine); co-primary OS and febrile neutropenia.
Maturity
early clinical

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