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Therapies Improve Outcomes in AML

Published: 2017-04-10 |

Author: Megan Garlapow, PhD |

Source: Cancer Therapy Advisor

Over 70% of all patients with acute myeloid leukemia (AML) are 60 years or older. Worse prognoses tend to characterize this elderly population, due to frailty and comorbidities. Precision medicines have improved outcomes in and understanding of AML, but targeted therapies are not always well-tolerated in this population. Increased remission, improved post-induction chemotherapy, and in cases of hematopoietic transplants, protection from active cytomegalovirus (CMV) infection could improve outcomes in this difficult-to-treat population.

Results from 2 clinical trials emphasize the importance of continuing generalized therapeutic advances in the treatment of AML. In one trial, published in the Journal of Clinical Oncology, the addition of androgens to maintenance treatment of elderly patients with AML significantly increased survival without affecting toxicity.

In the second trial, presented at Bone Marrow Transplant Tandem Meetings, treatment with a novel agent, letermovir, targeted active CMV in patients with hematological malignancies and other disorders who received donor hematopoietic transplants.

In the randomized, open-label phase 3 trial of the androgen norethandrolone, Treatment Outcome in Elderly Patients, reseatrchers assessed disease-free survival (DFS) by intention to treat, the primary outcome, among 330 patients 60 years or older with AML. Patients were randomly assigned to receive norethandrolone at 10 or 20 mg/day along with chemopherapy (165 patients) or to undergo chemotherapy alone (165 patients).

About three-quarters of patients (247) achieved complete or partial remission. Improvements in outcomes were time sensitive, occuring among patients who did not relapse in the first year. Among these patients, in the norethandrolone arm, 5-year DFS was 31.2%; in the chemopherapy alone arm, 5-year DFS was 16.2%. 

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