Meta‑analysis of the efficacy of venetoclax and azacitidine combination therapy and azacitidine monotherapy for treating acute myeloid leukemia

Yuqin Xie; Xueqin Wei; Weiwei Wang; Changsheng Liao; Pengfei Han; Yanhui Yu

doi:10.3892/etm.2024.12452

Meta‑analysis of the efficacy of venetoclax and azacitidine combination therapy and azacitidine monotherapy for treating acute myeloid leukemia

Exp Ther Med. 2024 Feb 26;27(4):164. doi: 10.3892/etm.2024.12452. eCollection 2024 Apr.

Authors

Yuqin Xie^{1

2}, Xueqin Wei^{1

2}, Weiwei Wang², Changsheng Liao², Pengfei Han³, Yanhui Yu¹

Affiliations

¹ Department of Hematology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi 046000, P.R. China.
² Graduate School, The First Clinical College of Changzhi Medical College, Changzhi, Shanxi 046000, P.R. China.
³ Department of Orthopedics, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi 046000, P.R. China.

Abstract

The present study aimed to compare the efficacy of combination therapy with venetoclax and azacitidine with that of azacytidine monotherapy in the treatment of acute myeloid leukemia (AML). The Web of Science, PubMed, Embase, The Cochrane Library, Weipu Database, Wanfang Digital Periodicals, Sinomed, China National Knowledge Infrastructure, ProQuest Dissertations and Theses and Cumulative Index to Nursing and Allied Health Literature were searched for publications on the treatment of AML with venetoclax combined with azacitidine or with azacitidine monotherapy. A total of 5,271 relevant studies were retrieved, of which 10 were included. Literature quality was evaluated according to the Cochrane systematic review methodology, and data were extracted for meta-analysis using Review Manager 5.4. The combination of venetoclax and azacitidine demonstrated greater overall efficacy than azacitidine monotherapy for AML treatment. Notably, combination therapy resulted in a higher frequency of complete remission. By contrast, combined treatment and monotherapy showed no significant differences in partial remission, whereas there was a statistically significant decrease in the frequency of no remission in the combination therapy group compared with in the monotherapy group. The results also revealed a significantly higher incidence of adverse reactions when venetoclax and azacitidine were combined in the treatment of AML compared with the observed rates in response to azacitidine monotherapy. Moreover, subgroup analyses showed that no statistically significant differences were observed between the two groups regarding adverse events, including hypokalemia and liver insufficiency. In conclusion, the combination of venetoclax and azacitidine was more effective than azacitidine alone, and had a good clinical application value in the treatment of AML. Although some adverse reactions occurred in response to the combination therapy, they did not significantly affect the prognosis of AML. To better evaluate the efficacy and safety of this treatment regimen, multicenter clinical studies with larger sample sizes are required.

Keywords: acute myeloid leukemia; azacitidine; combination therapy; meta-analysis; monotherapy; venetoclax.

Grants and funding

Funding: The present study was funded by the Scientific and Technological Innovation Programs of Higher Education Institutions in Shanxi (grant no. 2021L353) and the Natural Science Foundation for Young Scientists of Shanxi Province (grant no. 20210302124089).