This Common Cancer Treatment Might Help Patients Stay Healthier for Longer

Understanding how to keep leukemia in remission for longer in older patients remains a significant challenge in cancer treatment. While achieving complete remission through initial treatment is a major milestone, the disease often returns within months, making it essential to find better ways to maintain remission. A new study has now provided key insights into how continued treatment with azacitidine can help extend remission periods in elderly patients with acute myeloid leukemia, a type of blood cancer that affects the bone marrow and blood cells.

A team of researchers led by Dr. Esther Natalie Oliva from Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Italy, alongside scientists from institutions across Europe and Japan, conducted an in-depth investigation into the effects of azacitidine as a follow-up treatment. Their work, published in the International Journal of Molecular Sciences, analyzes how the body responds to azacitidine at a cellular level. Using advanced genetic sequencing, a technique used to analyze the DNA of cells to identify mutations or changes in genes, the team examined changes in leukemia-related genes before and after treatment to better understand how azacitidine helps prevent relapse.

Dr. Oliva and her team’s study observed elderly leukemia patients who had achieved remission after intensive chemotherapy, a treatment that uses powerful drugs to kill cancer cells or stop them from growing. These individuals were then assigned to receive either subcutaneous azacitidine or supportive medical care without additional treatment. The results showed that patients who received azacitidine stayed in remission for nearly twice as long as those who did not. This benefit remained even after several years, reinforcing the potential of azacitidine in helping patients stay free of disease.

One of the most notable findings was that specific genetic traits, such as mutations in the FANCA gene, were linked to a higher risk of relapse. The study found that patients with these genetic changes were significantly more likely to see their leukemia return. “Our findings help clarify how genetic changes after remission affect the likelihood of relapse and highlight why some patients may need additional treatment strategies,” explained Dr. Oliva. This insight could pave the way for more tailored treatment plans based on a patient’s genetic profile, a unique set of genetic characteristics that can influence how a person responds to treatment.

The researchers also emphasized that while subcutaneous azacitidine shows promise in extending remission, it has not yet been linked to an overall survival benefit. In contrast, oral azacitidine has demonstrated an improvement in overall survival, which is why oral azacitidine is currently commercialized whereas subcutaneous azacitidine is not.

Importantly, they reported that subcutaneous azacitidine was generally well tolerated, with the most common side effect being a low white blood cell count, a measure of immune system health that can affect the body’s ability to fight infections. No patients died before relapse, suggesting that azacitidine is a safe option for elderly individuals who have already undergone intensive treatment. These findings support previous research showing that azacitidine provides a safer alternative to more aggressive chemotherapy in older patients.

Looking ahead, the team plans to further explore how other genetic factors influence relapse in acute myeloid leukemia. The use of high-tech genetic screening, a test used to identify genetic mutations that may affect disease risk or treatment response, to monitor patients after remission could provide valuable insights into predicting treatment responses and identifying which patients would benefit most from azacitidine therapy. “These results suggest that understanding genetic factors can help refine treatment plans after remission, offering new hope for older leukemia patients,” Dr. Oliva noted.

Dr. Oliva and colleagues’ study marks an important step forward in the treatment of acute myeloid leukemia, highlighting the potential of azacitidine as a valuable follow-up therapy for elderly patients. By combining genetic analysis with clinical data, scientists continue to advance leukemia treatment, moving closer to a more personalized approach to cancer care, a method of tailoring medical treatment to an individual’s specific characteristics, including genetics and overall health.