Bernal T, Moreno AF, de LaIglesia A, Benavente C, García‐Noblejas A, Belmonte DG, Riaza R, Salamero O, Foncillas MA, Roldán A, Concepción VN, González LL, Bergua Burgués JM, Lorente de Uña S, Rodríguez‐Macías G, de la Fuente Burguera A, García Pérez MJ, López‐Lorenzo JL, Martínez P, Aláez C, Callejas M, Martínez‐Chamorro C, Roca JR, Barciela LA, Mena Durán AV, Gómez Correcha K, Lavilla Rubira E, Amigo ML, Vall‐llovera F, Garrido A, García‐Fortes M, de Miguel Llorente D, Leonardo AA, Cervero C, Jordá RC, Pérez‐Encinas MM, Zarzuela MP, Figuera A, Rad G, Martínez‐Cuadrón D, Montesinos P. Clinical outcomes after CPX-351 in patients with high-risk acute myeloid leukemia: A comparison with a matched cohort from the Spanish PETHEMA registry.
Cancer Med 2023;
12:14892-14901. [PMID:
37212507 PMCID:
PMC10417130 DOI:
10.1002/cam4.6120]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/28/2023] [Accepted: 05/10/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND
CPX-351 is approved for the treatment of therapy related acute myeloid leukemia (t-AML) and AML with myelodysplastic related changes (MRC-AML). The benefits of this treatment over standard chemotherapy has not been addressed in well matched cohorts of real-life patients.
METHODS
Retrospective analysis of AML patients treated with CPX-351 as per routine practice. A propensity score matching (PSM) was used to compare their main outcomes with those observed in a matched cohort among 765 historical patients receiving intensive chemotherapy (IC), all of them reported to the PETHEMA epidemiologic registry.
RESULTS
Median age of 79 patients treated with CPX-351 was 67 years old (interquartile range 62-71), 53 were MRC-AML. The complete remission (CR) rate or CR without recovery (CRi) after 1 or 2 cycles of CPX-351 was 52%, 60-days mortality 18%, measurable residual disease <0.1% in 54% (12 out of 22) of them. Stem cell transplant (SCT) was performed in 27 patients (34%), median OS was 10.3 months, and 3-year relapse incidence was 50%. Using PSM, we obtained two comparable cohorts treated with CPX-351 (n = 52) or IC (n = 99), without significant differences in CR/CRi (60% vs. 54%) and median OS (10.3 months vs. 9.1 months), although more patients were bridged to SCT in the CPX-351 group (35% vs. 12%). The results were confirmed when only 3 + 7 patients were included in the historical cohort. In multivariable analyses, SCT was associated with better OS (HR 0.33 95% CI: 0.18-0.59), p < 0.001.
CONCLUSION
Larger post-authorization studies may provide evidence of the clinical benefits of CPX-351 for AML in the real-life setting.
Collapse