🧪 Shorter, Smarter, Just as Strong? Rethinking Venetoclax Schedules in AML

Written By Daniel McCutchen
Shorter, Smarter, Just as Strong? Rethinking Venetoclax Schedules in AML

May 9

In the treatment of acute myeloid leukemia (AML), particularly for patients who cannot undergo intensive chemotherapy, emerging evidence is reshaping traditional expectations. A 2025 study published in Cancers by researchers at the University Hospital of Bern reveals that shortened venetoclax treatment cycles are not only feasible, but equally effective and safer than extended regimens.

This shift toward personalized dosing strategies was made possible in part by accurate drug level measurements using high-performance LC-MS/MS. At the heart of this accuracy was the use of a stripped-down matrix: Mass Spect Gold Human Stripped Serum.

🔬 Study Design

The study examined 75 AML patients receiving venetoclax with hypomethylating agents (HMAs), assessing differences in outcomes between shorter (≤14 days) and longer (>14 days) treatment durations.

  • Drug exposure: peak and trough venetoclax levels
  • Bone marrow recovery: platelet and neutrophil counts
  • Clinical results: complete remission (CR), progression-free survival (PFS), and overall survival (OS)

📊 What They Found

Shorter Cycles Work

Patients on 14-day or shorter regimens had similar CR rates (65%) as those on extended treatment—no loss in efficacy.

Drug Levels Weren’t Predictive

Venetoclax concentrations in plasma showed no correlation with remission or toxicity outcomes, regardless of peak or trough levels.

No Delays in Blood Count Recovery

Shorter schedules did not compromise hematologic recovery—neutrophil and platelet levels rebounded comparably across groups.

🔍 Behind the Precision

Researchers used ultra-sensitive UHPLC-MS/MS and multiple reaction monitoring (MRM) to measure venetoclax in blood samples at nanogram concentrations. Precision depended on minimizing interference—making matrix quality critical.

For this reason, they used a Mass Spect Gold Human Stripped Serum, a stripped human matrix that removes hormones and lipids. Its interference-free composition was key to clean, reproducible drug quantification.

  • Reliable pharmacokinetic profiles
  • Bioanalytical method development
  • Accurate low-abundance analyte detection

🌍 What This Means for Practice

  • Shorter venetoclax treatment may reduce toxicity without sacrificing efficacy
  • Therapeutic drug monitoring remains valuable, especially with precise matrices
  • Matrix selection matters—as shown with Mass Spect Gold Human Stripped Serum

🗾 Final Thoughts

This study signals a refinement in AML care, where data-backed personalization takes precedence over tradition. It also underlines a core principle in diagnostics: measurement matters, and what you measure with matters just as much.

📙 Reference

Schüpbach et al. (2025). Impact of Venetoclax Treatment Schedule on Hematologic Recovery and Treatment Response in AML Patients Unfit for Intensive Chemotherapy. Cancers, 17(7), 1138. https://doi.org/10.3390/cancers17071138

Impact of Venetoclax Treatment Schedule on Hematologic Recovery and Treatment Response in AML Patients Unfit for Intensive Chemotherapy

Download PDF

Download

Daniel McCutchen