Ivosidenib is an IDH1 inhibitor used to treat relapsed/refractory acute myeloid leukemia (AML) patients carrying IDH1 mutations or newly diagnosed AML patients who cannot receive intensified chemotherapy. The duration of its medication needs to be personalized according to the disease status, treatment response, and tolerance, and usually needs to be continued until disease progression or intolerable toxicity occurs.

1 standard treatment cycle

(1) Recurrent/refractory AML: Continuous medication is required until disease progression or unacceptable toxicity occurs, with a median treatment duration of 4.3 months in clinical trials.

(2) Newly diagnosed AML: As a continuous treatment plan, long-term medication is required until disease progression, and some patients may use it for more than 2 years.

2. Efficacy evaluation and adjustment

(1) Patients with complete remission (CR): It is recommended to continue with treatment and regularly monitor for minimal residual disease (MRD).

(2) Stable Disease (SD) patients: If well tolerated, medication can be continued, and treatment benefits will be evaluated every 3-6 months.

3 Indications for discontinuation of medication

(1) Disease progression: including hematological or extramedullary recurrence, requiring a change in treatment plan.

(2) Intolerable toxicity: Adverse reactions of grade 3 or above, such as differentiation syndrome and QT interval prolongation.

4 Special precautions

(1) Elderly patients: Age does not affect the duration of medication, but it is necessary to strengthen the monitoring of adverse reactions.

(2) Liver and kidney dysfunction: Mild to moderate injuries do not require adjustment of treatment course, while severe injuries require individualized assessment.