Venetoclax TDM Reduces Toxicity Risk in Posaconazole-Treated AML Patients

This real-world analysis quantifies how posaconazole distorts venetoclax exposure and links higher exposure to myelosuppression, supporting therapeutic drug monitoring in routine acute myeloid leukemia care.

venetoclaxposaconazoleazacitidineBCL-2 inhibitorazole antifungalstherapeutic drug monitoringacute myeloid leukemiaCYP3A4 interactionneutropeniaobservational studypharmacokinetics Oncology Pharmacy

Background Information

Venetoclax levels spike with posaconazole: TDM is essential.

Venetoclax is used in acute myeloid leukemia (AML) treatment, but its interaction with azole antifungals like posaconazole requires close monitoring to manage toxicity. Posaconazole increased venetoclax's variability, concentration, and accumulation despite dose adjustments, leading to necessary venetoclax dosage changes. Therapeutic drug monitoring (TDM) of venetoclax is crucial in the presence of posaconazole to minimize toxicity. The correlation with efficacy was not demonstrated, highlighting monitoring's focus on safety. Venetoclax TDM reduces toxicity from posaconazole interactions in AML treatment.

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Authors: Sani B, Cignetti A, Leporati M, Sommariva S, Armenio M, Tenace V, Savi A, Umurungi J, Fornari G, Busso S, Canevaro A, Bisognin I, Marini S, Piana M, Cilloni D, Gaidano V

Citation: Sani B, Cignetti A, Leporati M, et al. Real-World Experience with Venetoclax Therapeutic Drug Monitoring in Acute Myeloid Leukemia: Role of Posaconazole, Correlation with Safety and Efficacy. Oncology research. 2026;34(8):12. doi:10.32604/or.2026.078245

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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