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Venetoclax + Chidamide + Azacitidine + Decitabine + MAG (VCA followed by D-MAG) is a multi-agent sequential combination regimen being evaluated for the treatment of elderly, previously untreated acute myeloid leukemia (AML). The regimen is structured into two phases: an induction phase (VCA) consisting of venetoclax (a BCL-2 inhibitor), chidamide (a histone deacetylase inhibitor), and azacitidine (a hypomethylating agent), followed by a consolidation phase (D-MAG) consisting of decitabine (a hypomethylating agent) and the MAG regimen (mitoxantrone, cytarabine, and G-CSF). This combination is designed to exploit synergistic epigenetic modulation and apoptosis induction to improve complete remission rates and event-free survival in elderly AML patients who are ineligible for or intolerant of intensive chemotherapy.
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