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Comparison of Hypomethylating Agent Plus Venetoclax With CPX-351 in Secondary AML

By: Kelly M. Hennessey, PhD
Posted: Friday, April 9, 2021

Vinod Pullarkat, MD of the City of Hope National Medical Center, Duarte, California, and colleagues analyzed the outcomes of patients with secondary acute myeloid leukemia (AML) who received either a hypomethylating agent plus venetoclax therapy or CPX-351—liposomal daunorubicin/cytarabine—for remission induction. They found that therapy with either regimen showed promising response rates in patients with secondary AML when compared with patients historically treated with 7+3 chemotherapy. Their results were published in the American Journal of Hematology.

“[These] data support [the] development of prospective trials in secondary AML to determine the most effective front-line regimen in this high-risk AML subgroup,” concluded the researchers.

In this retrospective study, a total of 50 patients with secondary AML met eligibility criteria. Of the total, 30 patients were treated with a hypomethylating agent plus venetoclax and 20 patients received CPX-351 therapy. Complete remission with hematologic recovery was achieved by 33% (n = 7) of patients given the combination therapy and 40% (n = 4) of those given CPX-351. The composite complete response rate (complete remission plus complete remission with hematologic recovery) was 70% versus 50% among patients treated with the combination therapy compared with CPX-35; no difference in overall survival or leukemia-free survival between the groups was observed.

Researchers found that 65% of patients who were treated with CPX-351 induction underwent allogeneic stem cell transplantation, compared with 35% of patients treated with a hypomethylating agent plus venetoclax. There appeared to be no difference in terms of overall survival or leukemia-free survival post–allogeneic stem cell transplantation after induction with either treatment.

Disclosure: The study authors reported no conflicts of interest.


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