Can Adding E-Selectin Antagonist to Chemotherapy Improve Outcomes in AML?
Posted: Friday, November 12, 2021
For patients with relapsed or refractory acute myeloid leukemia (AML), the addition of the E-selectin antagonist uproleselan to chemotherapy appeared to be beneficial for patient outcomes, according to the phase I/II study (ClinicalTrials.gov identifier NCT02306291) published in the journal Blood. These findings provide a strong rationale for phase III randomized confirmatory studies, as the addition of uproleselan resulted in low induction mortality and low rates of mucositis, explained Pamela S. Becker, MD, PhD, of the University of Washington, Seattle, and colleagues.
A total of 91 patients with relapsed or refractory AML were recruited for the study. Patients were stratified into three treatment groups. The first group (n = 19) received 10 mg/kg of uproleselan twice daily. The second group (n = 47) received 10 mg/kg of uproleselan plus mitoxantrone, etoposide, and cytarabine. The third group (n = 25) received 10 mg/kg of uproleselan plus cytarabine and idarubicin (7+3). All patients in groups 1 and 2 had established diagnoses of relapsed or refractory AML, whereas the patients in group 3 were newly diagnosed.
The study findings revealed that for patients in group 1, no dose-limiting toxicities were evident following treatment. For patients in group 2, the median overall survival was 8.8 months, and the remission rate was 41%. Moreover, patients in group 3 had a remission rate of 72%, and the median overall survival was 12.6 months. Furthermore, as compared with patients with primary refractory AML, those with relapsed AML had higher levels of E-selectin ligand expression on leukemic blasts.
Disclosure: For full disclosures of the study authors, visit ashpublications.org.