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How will you utilize the PARADIGM study results from ASH 2025, comparing azacitidine/venetoclax to intensive induction chemotherapy for fit patients with newly diagnosed AML?

Aza/ven patients had better EFS/QoL with a greater proportion of patients who successfully got to a stem cell transplant. Provided that the OS data is yet to mature, do these results change your current clinical practice?
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Which fit patients will you offer aza/ven for newly diagnosed AML in lieu of intensive induction chemotherapy in light of PARADIGM results from ASH 2025?

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1 Answer
Mednet MemberInvited Expert
Hematology · University of Chicago
Answered on · Updated on

It was very exciting to see PARADIGM presented as a plenary at ASH, and I look forward to the manuscript! Interpreting the findings in the context of the enrolled patients is very important. The median age of enrolled patients was approximately 65 years in both arms, and ~75% of enrolled patients had adverse-risk disease by ELN22. There were very few enrolled patients with ELN22 favorable-risk and intermediate-risk disease, so it's difficult to have meaningful takeaways from those populations. With this in mind, for fit patients (particularly over the age of 60) with ELN22 adverse-risk disease who are allogeneic transplant candidates, I feel that PARADIGM supports the use of HMA + venetoclax over standard intensive chemotherapy, given the i...

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