Real-world experience of venetoclax target dosing with concomitant posaconazole in adult patients with acute myeloid leukemia
Venetoclax creates ongoing challenges when combined with posaconazole due to a known drug-drug interaction. Herein, we investigated the safety between venetoclax 100mg and 70mg when administered with posaconazole in acute myeloid leukemia in this single-center, retrospective comparative analysis. Primary safety endpoints were incidence/duration of cytopenias and incidence of tumor lysis syndrome during the first treatment cycle. A total of 113 patients received venetoclax 100mg while 32 patients received 70mg. Comparing venetoclax 100mg vs 70mg, no statistically significant differences were seen in grade 3 neutropenia (89.4% vs 84.4%, p=0.53), grade 4 neutropenia (88.5% vs 87.5%, p=1.0), median duration in days of grade 4 neutropenia (23 [range 1–105] vs 28 [range 1-81], p=0.35), grade 3/4 anemia (88.5% vs 84.4%, p=0.55), grade 3/4 thrombocytopenia (81.4% vs 87.5%, p=0.42), or tumor lysis syndrome (2.7% vs 6.3%, p=0.30). In adult patients with acute myeloid leukemia, a target dose of venetoclax 100mg with posaconazole may be a safe alternative. Further studies assessing dose optimization are warranted.
Authors
- Nicole R. Grieselhuber (ORCID: https://orcid.org/0000-0003-3495-5932)
- Bradley W. Blaser (ORCID: https://orcid.org/0000-0002-3168-5423)
- Shivani Handa (ORCID: https://orcid.org/0000-0002-1932-6209)
- Megan Fleming (ORCID: https://orcid.org/0000-0002-3024-0801)
- Kristin L Koenig (ORCID: https://orcid.org/0000-0002-2071-3169)
- Uma Borate (ORCID: https://orcid.org/0000-0002-4958-4962)
- Kieran Sahasrabudhe (ORCID: https://orcid.org/0000-0001-8919-1189)
- Alice S. Mims (ORCID: https://orcid.org/0000-0002-8971-2199)
- Gregory K. Behbehani (ORCID: https://orcid.org/0000-0002-9493-3607)
- Shinae Lee (ORCID: https://orcid.org/0000-0001-5594-6977)
- Tracelyn Freeman
- Jayanshu Jain
- James S. Blachly (ORCID: https://orcid.org/0000-0002-4275-5562)
- Allyson Waller
- Ying Huang (ORCID: https://orcid.org/0000-0001-9910-1212)
- Meixiao Long
- Karilyn Larkin (ORCID: https://orcid.org/0000-0002-1898-9836)
- Andrew Srisuwananukorn (ORCID: https://orcid.org/0000-0002-8736-8726)
- Pooja S. Kumar
- Kelsey McMillan
- Ann-Kathrin Eisfeld
- Alma Habib (ORCID: https://orcid.org/0000-0003-4429-3602)
- Natalia Hartzler
Institutions
- University of Wisconsin Carbone Cancer Center (US)
- The Ohio State University (US)
Publication Details
- Journal
- Frontiers in Hematology
- Published
- 2025-09-23
- DOI
- https://doi.org/10.3389/frhem.2025.1664425
- Primary Topic
- Acute Myeloid Leukemia Research
- Type
- article
- Field-Weighted Citation Impact
- 0.00