TY - JOUR
T1 - Adjunctive Volasertib in Patients with Acute Myeloid Leukemia not Eligible for Standard Induction Therapy
T2 - A Randomized, Phase 3 Trial
AU - Dohner, Hartmut
AU - Symeonidis, Argiris
AU - Deeren, Dries
AU - Demeter, Judit
AU - Sanz, Miguel A.
AU - Anagnostopoulos, Achilles
AU - Esteve, Jordi
AU - Fiedler, Walter
AU - Porkka, Kimmo
AU - Kim, Hee Je
AU - Lee, Je Hwan
AU - Usuki, Kensuke
AU - D'Ardia, Stefano
AU - Won Jung, Chul
AU - Salamero, Olga
AU - Horst, Heinz August
AU - Recher, Christian
AU - Rousselot, Philippe
AU - Sandhu, Irwindeep
AU - Theunissen, Koen
AU - Thol, Felicitas
AU - Dohner, Konstanze
AU - Teleanu, Veronica
AU - Deangelo, Daniel J.
AU - Naoe, Tomoki
AU - Sekeres, Mikkael A.
AU - Belsack, Valerie
AU - Ge, Miaomiao
AU - Taube, Tillmann
AU - Ottmann, Oliver G.
N1 - Publisher Copyright:
© 2021 Wolters Kluwer Health. All rights reserved.
PY - 2021/8/2
Y1 - 2021/8/2
N2 - In this phase 3 trial, older patients with acute myeloid leukemia ineligible for intensive chemotherapy were randomized 2:1 to receive the polo-like kinase inhibitor, volasertib (V; 350 mg intravenous on days 1 and 15 in 4-wk cycles), combined with low-dose cytarabine (LDAC; 20 mg subcutaneous, twice daily, days 1-10; n = 444), or LDAC plus placebo (P; n = 222). Primary endpoint was objective response rate (ORR); key secondary endpoint was overall survival (OS). Primary ORR analysis at recruitment completion included patients randomized ≥5 months beforehand; ORR was 25.2% for V+LDAC and 16.8% for P+LDAC (n = 371; odds ratio 1.66 [95% confidence interval (CI), 0.95-2.89]; P = 0.071). At final analysis (≥574 OS events), median OS was 5.6 months for V+LDAC and 6.5 months for P+LDAC (n = 666; hazard ratio 0.97 [95% CI, 0.8-1.2]; P = 0.757). The most common adverse events (AEs) were infections/infestations (grouped term; V+LDAC, 81.3%; P+LDAC, 63.5%) and febrile neutropenia (V+LDAC, 60.4%; P+LDAC, 29.3%). Fatal AEs occurred in 31.2% with V+LDAC versus 18.0% with P+LDAC, most commonly infections/infestations (V+LDAC, 17.1%; P+LDAC, 6.3%). Lack of OS benefit with V+LDAC versus P+LDAC may reflect increased early mortality with V+LDAC from myelosuppression and infections.
AB - In this phase 3 trial, older patients with acute myeloid leukemia ineligible for intensive chemotherapy were randomized 2:1 to receive the polo-like kinase inhibitor, volasertib (V; 350 mg intravenous on days 1 and 15 in 4-wk cycles), combined with low-dose cytarabine (LDAC; 20 mg subcutaneous, twice daily, days 1-10; n = 444), or LDAC plus placebo (P; n = 222). Primary endpoint was objective response rate (ORR); key secondary endpoint was overall survival (OS). Primary ORR analysis at recruitment completion included patients randomized ≥5 months beforehand; ORR was 25.2% for V+LDAC and 16.8% for P+LDAC (n = 371; odds ratio 1.66 [95% confidence interval (CI), 0.95-2.89]; P = 0.071). At final analysis (≥574 OS events), median OS was 5.6 months for V+LDAC and 6.5 months for P+LDAC (n = 666; hazard ratio 0.97 [95% CI, 0.8-1.2]; P = 0.757). The most common adverse events (AEs) were infections/infestations (grouped term; V+LDAC, 81.3%; P+LDAC, 63.5%) and febrile neutropenia (V+LDAC, 60.4%; P+LDAC, 29.3%). Fatal AEs occurred in 31.2% with V+LDAC versus 18.0% with P+LDAC, most commonly infections/infestations (V+LDAC, 17.1%; P+LDAC, 6.3%). Lack of OS benefit with V+LDAC versus P+LDAC may reflect increased early mortality with V+LDAC from myelosuppression and infections.
UR - https://www.scopus.com/pages/publications/85112389393
U2 - 10.1097/HS9.0000000000000617
DO - 10.1097/HS9.0000000000000617
M3 - Article
AN - SCOPUS:85112389393
SN - 2572-9241
VL - 5
SP - E617
JO - HemaSphere
JF - HemaSphere
IS - 8
ER -