venetoclax + azacitidine + cytarabine + idarubicin + granulocyte colony-stimulating factor

The VA-CIG regimen is an intensive induction therapy combination being evaluated for the treatment of previously untreated, fit patients with acute myeloid leukemia (AML). This multi-drug approach combines the BCL-2 inhibitor venetoclax with the hypomethylating agent azacitidine and a modified intensive chemotherapy backbone consisting of idarubicin, low-dose cytarabine, and granulocyte colony-stimulating factor (G-CSF). Venetoclax works by selectively inhibiting B-cell lymphoma 2 (BCL-2), an anti-apoptotic protein often overexpressed in AML cells, thereby restoring the apoptotic process. Azacitidine acts as a DNA methyltransferase inhibitor, promoting gene re-expression and cell differentiation. The chemotherapy components, cytarabine and idarubicin, induce direct DNA damage and inhibit DNA synthesis. G-CSF is included to accelerate neutrophil recovery and potentially sensitize leukemic blasts to the cytotoxic effects of the chemotherapy. This regimen is primarily being developed and studied by the Beijing 302 Hospital (also known as the Fifth Medical Center of the PLA General Hospital).

Other names

VA-CIG regimenVenetoclax, Azacitidine, Cytarabine, Idarubicin, G-CSF