CPX-351 effective against acute myeloid leukaemia
CPX-351, a liposomal encapsulation of cytarabine and daunorubicin, is a promising treatment option for patients with therapy-related acute myeloid leukaemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC), leading to high rates of treatment response and good survival outcomes, a recent study has found.
Researchers enrolled 188 patients (median age 65 years), of whom 29 percent had t-AML while the remaining had AML-MRC. Most participants (86 percent) received one induction cycle of CPX-351 while 14 percent were given two cycles. Sixty-two percent underwent subsequent allogeneic haematopoietic cell transplantation (allo-HCT).
Following CPX-351 induction, 47 percent (n=85) of patients reached complete remission (CR) or CR with incomplete haematologic recovery (CRi). Meanwhile, 20 percent (n=35) achieved a morphologic leukaemia-free state.
Flow cytometry data was available for 36 patients who achieved CR/CRi, of whom 64 percent (n=24) showed measurable residual disease negativity.
Multinomial logistic regression analysis showed that of all potential correlates, only a noncomplex karyotype remained significantly and independently predictive of a higher CR/CRi rate (hazard ratio [HR], 4.3, 95 percent confidence interval [CI], 1.9–9.2; p=0.0001).
On the other hand, pretreatment with hypomethylating agents (HR, 2.4, 95 percent CI, 1.1–5.3; p=0.02) and adverse genetic risk as defined by the European LeukaemiaNet (HR, 4.2, 95 percent CI, 1.9–8.9; p<0.0001) were negative predictors of overall survival (OS). The median OS in the study cohort was 21 months, with a corresponding estimated 1-year rate of 64 percent.