Does Waiting for Mutational Test Results Delay Time to Treatment for Patients Newly Diagnosed With AML?

Researchers assessed the turnaround time of mutational tests in patients with newly diagnosed acute myeloid leukemia (AML) and the time from diagnosis to treatment initiation. Their findings showed that results were received within the common time from diagnosis to treatment initiation. The researchers presented their abstract at the 12th annual meeting of the Society of Hematologic Oncology (SOHO) 2024 in Houston, TX.

In a retrospective, real-world-evidence study, Smith and colleagues sought to determine if waiting for mutational test results delayed treatment initiation for patients newly diagnosed (ND) with AML who were ineligible for intensive chemotherapy. According to the researchers, recent studies have challenged standard practice by “supporting waiting 2 weeks for mutational testing to initiate treatment for most patients.”

Included in their study were 283 patients with ND mutant isocitrate dehydrogenase 1 (mIDH1) AML who were ineligible for intensive chemotherapy (ICi). The total number was divided into two treatment cohorts: ivosidenib (IVO) + hypomethylating agent (HMA) (n = 182) and venetoclax (VEN) + HMA (n = 101).

The median turnaround from mLDHI1 test to results was 7 days in each cohort. Further, two-thirds of patients (66%) had results by days 11 (IVO) and 9 (VEN). The median time from test results to treatment initiation was 1 (IVO) and 4 (VEN). Looking at the median time from diagnosis to treatment, the researchers found it was 14 days (IVO) and 20 days (VEN), with two-thirds of patients beginning treatment by days 21 (IVO) and 24 (VEN).

“Over two-thirds (66%) of patients with ND ICi AML received mutational test

results in [less than or equal to] 11 days, well within the common time from diagnosis to treatment initiation,” the researchers concluded. “Patients receiving IVO+HMA typically had shorter time to treatment than patients receiving VEN+HMA. The efficacy of IVO+HMA reported earlier and the short typical wait for test results relative to treatment start suggest the opportunity for effective targeted therapy need not be missed.”

Reference:

Smith BD, Lachowiez CA, Ambinder AJ, et al. Waiting for mutational test results does not delay time to treatment for newly diagnosed AML ineligible for intensive chemo. In: Proceedings of the Society of Hematologic Oncology 2024 Annual Meeting. Clin Lymphoma Myeloma Leuk. 2024 Sept;9(24);Supplement 1:S331.