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Reformulating acute myeloid leukemia: liposomal cytarabine and daunorubicin (CPX-351) as an emerging therapy for secondary AML
| Content Provider | Semantic Scholar |
|---|---|
| Author | Chen, Evan C. Fathi, Amir T. Brunner, Andrew M. |
| Copyright Year | 2018 |
| Abstract | Despite increasing understanding of the pathobiology of acute myeloid leukemia (AML), outcomes remain dismal particularly for patients over the age of 60 years, a population enriched for therapy-related AML (tAML) and secondary AML (sAML). For decades, the standard of care for AML has been the combination of cytarabine and daunorubicin, typically delivered in combination as "7 + 3" induction. In 2017, a liposomal-encapsulated combination of daunorubicin and cytarabine (CPX-351, Vyxeos) was approved by the US Food and Drug Administration (FDA) for use in the treatment of newly diagnosed tAML or AML with myelodysplasia-related changes (AML-MRCs). CPX-351 was designed to deliver a fixed 5:1 molar ratio of cytarabine and daunorubicin, respectively, based on the hypothesis that ratiometric dosing may be more effective than the delivery of either drug at their maximum tolerated dose. In a Phase III trial of older patients with sAML aged 60-75 years, CPX-351 was compared to "7 + 3" and was associated with a higher overall survival, event-free survival, and higher rates of complete remission (CR) and CR with incomplete hematologic recovery (CRi). These data were the basis for the approval of this new drug for use in the treatment of AML, but questions remain regarding how to best administer this agent across AML subgroups. Future directions include evaluating dose intensification with CPX-351, combining this agent with targeted therapies, and better understanding the mechanism of improved responses in tAML and AML-MRC, two entities that are historically less responsive to cytotoxic agents. In summary, CPX-351 offers an exciting new change to the landscape of AML therapy. |
| Starting Page | 3425 |
| Ending Page | 3434 |
| Page Count | 10 |
| File Format | PDF HTM / HTML |
| PubMed reference number | 29928134v1 |
| Alternate Webpage(s) | https://doi.org/10.2147/OTT.S141212 |
| DOI | 10.2147/ott.s141212 |
| Journal | OncoTargets and therapy |
| Volume Number | 11 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Alopecia Amphotericin B Anthracyclines Celgene Conflict (Psychology) Consultation Cytarabine liposome Daunorubicin Disease-Free Survival Evidence of Contractor Compliance Document Gemtuzumab ozogamicin Hematological Disease Hematology (discipline) Importal Leukemia, Myelocytic, Acute Liposomal Cytarabine-Daunorubicin CPX-351 Liposomes MYELODYSPLASTIC SYNDROME Manuscripts Maximum Tolerated Dose Overall Survival Partial Patients Therapeutic procedure United States Food and Drug Administration benefit childhood acute lymphoblastic leukemia in remission midostaurin recurrent childhood acute myeloid leukemia secondary acute myeloid leukemia |
| Content Type | Text |
| Resource Type | Article |
