Inferior Outcome of Addition of the Aminopeptidase Inhibitor Tosedostat to Standard Intensive Treatment for Elderly Patients with AML and High Risk MDS.

Janssen, Jeroen; Löwenberg, Bob; Manz, Markus; Bargetzi, Mario; Biemond, Bart; Borne, Peter von dem; Breems, Dimitri; Brouwer, Rolf; Chalandon, Yves; Deeren, Dries; Efthymiou, Anna; Gjertsen, Bjørn-Tore; Graux, Carlos; Gregor, Michael; Heim, Dominik; Hess, Urs; Hoogendoorn, Mels; Jaspers, Aurelie; Jie, Asiong; Jongen-Lavrencic, Mojca; ... (2021). Inferior Outcome of Addition of the Aminopeptidase Inhibitor Tosedostat to Standard Intensive Treatment for Elderly Patients with AML and High Risk MDS. Cancers, 13(4) MDPI AG 10.3390/cancers13040672

[img] Text
cancers-13-00672.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (1MB)

Treatment results of AML in elderly patients are unsatisfactory. We hypothesized that addition of tosedostat, an aminopeptidase inhibitor, to intensive chemotherapy may improve outcome in this population. After establishing a safe dose in a run-in phase of the study in 22 patients, 231 eligible patients with AML above 65 years of age (median 70, range 66-81) were randomly assigned in this open label randomized Phase II study to receive standard chemotherapy (3+7) with or without tosedostat at the selected daily dose of 120 mg (n = 116), days 1-21. In the second cycle, patients received cytarabine 1000 mg/m2 twice daily on days 1-6 with or without tosedostat. CR/CRi rates in the 2 arms were not significantly different (69% (95% C.I. 60-77%) vs 64% (55-73%), respectively). At 24 months, event-free survival (EFS) was 20% for the standard arm versus 12% for the tosedostat arm (Cox-p = 0.01) and overall survival (OS) 33% vs 18% respectively (p = 0.006). Infectious complications accounted for an increased early death rate in the tosedostat arm. Atrial fibrillation was more common in the tosedostat arm as well. The results of the present study show that the addition of tosedostat to standard chemotherapy does negatively affect the therapeutic outcome of elderly AML patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Pabst, Thomas Niklaus

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2072-6694

Publisher:

MDPI AG

Language:

English

Submitter:

Rebeka Gerber

Date Deposited:

27 Sep 2021 12:08

Last Modified:

27 Sep 2021 12:08

Publisher DOI:

10.3390/cancers13040672

PubMed ID:

33562393

Uncontrolled Keywords:

AML aminopeptidase inhibitor clinical trial elderly high-risk MDS tosedostat

BORIS DOI:

10.48350/159229

URI:

https://boris.unibe.ch/id/eprint/159229

Actions (login required)

Edit item Edit item
Provide Feedback