Ivosidenib, as a targeted therapy for IDH1 mutant acute myeloid leukemia, usually requires long-term use until disease progression or intolerable toxicity occurs. Its medication cycle needs to be dynamically adjusted according to individual treatment response, and there is no pre-set fixed course of treatment.

The necessity of long-term medication

(1) Disease characteristics: Leukemia cells with IDH1 mutations require continuous inhibition of mutant protein activity, and discontinuation of medication may lead to disease recurrence.

(2) Mechanism of action: As a small molecule inhibitor, it is necessary to maintain blood drug concentration to block abnormal metabolic pathways, and short-term treatment is difficult to eradicate malignant clones.

2 Standard Medication Plans

(1) Basic treatment course: 500mg daily continuous administration, 28 day cycle use, effective for several years.

(2) Maintenance therapy: After achieving complete remission, it is recommended to maintain it for at least 6 months, and some patients may need to continue medication for more than 2 years.

3. Basis for adjusting treatment courses

(1) Efficacy monitoring: Through regular bone marrow biopsy evaluation, patients with sustained remission can extend the duration of medication.

(2) Toxicity management: When adverse reactions such as QT prolongation occur, it is necessary to suspend or reduce the dosage, but it is not a permanent indication for discontinuation.

4 Special precautions

(1) Liver dysfunction: Patients with moderate to severe injuries need to adjust to 250mg/day, but it does not affect the overall duration of medication.

(2) Elderly patients: need to strengthen electrocardiogram monitoring, but age itself does not limit long-term treatment.