ASH 2019: Can Rapid Precision Medicine Help Older Adults With AML?

When someone is diagnosed with acute myeloid leukemia (AML), doctors typically initiate treatment within 24-48 hours of diagnosis given the aggressive nature of the disease. This urgency to treat precludes the use of ancillary test results, such as genomic profiling, to guide upfront treatment decision making and clinical management. Yet, understanding the genomic alterations associated with a patient’s disease is critical and can help enable oncologists to identify the most effective, targeted treatment options.

Though several targeted therapies have recently been approved in AML, with more in development, the standard approach to treatment has changed little in the past 40 years. More treatment options are needed, especially for people over age 60. At Foundation Medicine, we continue to look for ways to bring the value of our comprehensive genomic profiling (CGP) platform to patients with blood cancers, like those with AML, who have urgent needs and few options.

At the American Society of Hematology (ASH) meeting in Orlando, one of the highlights for me was the first presentation of clinical outcome data associated with the Leukemia & Lymphoma Society’s Beat AML Master trial. The findings confirm the feasibility of delivering genomic profiling results within seven days of diagnosis, the safety of waiting up to seven days to initiate treatment, and the value of applying a precision medicine approach to inform treatment assignment. Foundation Medicine is proud to partner with the Leukemia & Lymphoma Society, as we have a shared vision for improving the lives of people living with AML.

IMPROVING AML OUTCOMES THROUGH PRECISION MEDICINE

The Beat AML Trial uses a precision medicine approach for the treatment of older patients with newly diagnosed AML, by incorporating upfront molecular profiling at the time of diagnosis.¹ The genomic profile of the leukemia is then used to assign patients to different treatment arms based upon the dominant leukemia-associated mutations. The trial allows for more rapid assessment of novel or targeted treatments in defined patient populations with the potential to significantly advance precision medicine for older AML patients. The results presented at ASH are the first of these outcomes data to be shared, and they show precision medicine can lead to a lower early death rate and improved overall survival in patients with AML compared to those who were treated with standard therapy (median 12.8 months vs. 3.9 months, p0.0001).

UNLOCKING THE FUTURE OF BLOOD CANCER CARE

The findings from the Beat AML Master trial offer new insights that, we believe, can help change clinical practice because they validate a framework for rapid precision medicine that improves outcome. Through our ongoing collaboration with the Leukemia & Lymphoma Society, we’re excited to see progress being made toward the care of older adults with AML, a population that is often underrepresented in clinical trials. We hope these findings lead to more effective treatment options, and ultimately, longer and improved quality of life for all patients afflicted with AML.

Because blood cancers are so complex, they require a sophisticated strategy to understand each patient’s unique cancer as well as the treatments that have the best chance at improving survival. As the data at ASH demonstrate, comprehensive genomic profiling in blood cancers can help us make enormous strides to better understand, diagnose and treat such diseases. We’re committed to helping unravel the molecular complexity of blood cancers so that more people can benefit from precision medicine.