Table 3 Comparison of available therapies for unfit patients with newly-diagnosed IDH1/2 mutated acute myeloid leukemia.
From: Newly diagnosed acute myeloid leukemia in unfit patients: 2026 treatment algorithms
Ivosidenib | Ivosidenib + Azacitidine | Ivosidenib + Azacitidine vs. placebo + Azacitidine | Ivosidenib + Azacitidine-Ven or Ivosidenib/enasidenib + Decitabine-Ven | Enasidenib | Enasidenib + Azacitidine vs. Azacitidine | Venetoclax (Ven) + Azacitidine vs. placebo + Azacitidine | |
|---|---|---|---|---|---|---|---|
1-year survival | 51.1% | 82% | – | 2-year survival 72% (IDH1) 67% (IDH2) | – | 72% vs. 70% | – |
CR/CRh (CR) | 42.4% (30.3%) | 69.6% (60.9%) | 53% vs. 18% (47% vs. 15%) | 86% (62%) (IDH1) 100% (83%) (IDH2) | 21% (18%) | 57% vs. 18% (54% vs. 12%) | 67% vs. 9% (IDH1) (27% vs. 0%) 86% vs. 11% (IDH2) (56% vs. 6%) |
IDHi Adverse events | Differentiation syndrome (9%) Qtc prolongation (9%) | Differentiation syndrome (17%) Qtc prolongation (26%) | Febrile neutropenia (28%) Differentiation syndrome (14%) | Infections (42%) Differentiation syndrome (5%) | ↑ bilirubin (31%) Nausea (23%) Anorexia (18%) Rash (18%) | ↓ platelets (37%) Neutropenia (37%) | Febrile neutropenia (29.6%) Pneumonia (21%) |
Median Overall survival | 12.6 months | Not estimable | 24 vs. 7.9 months | Not reached | 11.3 months | 22 vs. 22.3 months | 15.2 vs. 2.2 months (IDH1) NR vs. 13 months (IDH2) |
Median age | 76.5 years | 76 years | 76 vs. 75.5 years | 71 years | 77 years | 75 years | 76 vs. 77.5 years |
N | 34 | 23 | 72 vs. 74 | 60 | 39 | 68 vs. 33 | 81 vs. 28 |
Reference | Roboz et al., Blood 2020 | DiNardo et al., JCO 2020 | Montesinos et al., NEJM 2022 | DiNardo et al., JCO 2025 | Pollyea et al., Leukemia 2019 | DiNardo et al., Lancet Oncol 2021 | Pollyea et al., Clin Cancer Res 2022 |
