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Clinical Trial
. 2013 Mar 1;31(7):923-9.
doi: 10.1200/JCO.2012.45.2177. Epub 2012 Nov 5.

Bortezomib added to daunorubicin and cytarabine during induction therapy and to intermediate-dose cytarabine for consolidation in patients with previously untreated acute myeloid leukemia age 60 to 75 years: CALGB (Alliance) study 10502

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Clinical Trial

Bortezomib added to daunorubicin and cytarabine during induction therapy and to intermediate-dose cytarabine for consolidation in patients with previously untreated acute myeloid leukemia age 60 to 75 years: CALGB (Alliance) study 10502

Eyal C Attar et al. J Clin Oncol. .

Abstract

Purpose: The purpose of this study was to determine remission induction frequency when bortezomib was combined with daunorubicin and cytarabine in previously untreated older adults with acute myeloid leukemia (AML) and safety of bortezomib in combination with consolidation chemotherapy consisting of intermediate-dose cytarabine (Int-DAC). VSports手机版.

Patients and methods: Ninety-five adults (age 60 to 75 years; median, 67 years) with previously untreated AML (including therapy-related and previous myelodysplastic syndrome) received bortezomib 1. 3 mg/m(2) intravenously (IV) on days 1, 4, 8, and 11 with daunorubicin 60 mg/m(2) on days 1 through 3 and cytarabine 100 mg/m(2) by continuous IV infusion on days 1 through 7. Patients who achieved complete remission (CR) received up to two courses of consolidation chemotherapy with cytarabine 2 gm/m(2) on days 1 through 5 with bortezomib. Three cohorts with escalating dose levels of bortezomib were tested (0. 7, 1. 0, and 1. 3 mg/m(2)). Dose-limiting toxicities were assessed during the first cycle of consolidation. The relationship between cell surface expression of CD74 and clinical outcome was assessed V体育安卓版. .

Results: Frequency of CR was 65% (62 of 95), and 4% of patients (four of 95) achieved CR with incomplete platelet recovery (CRp). Eleven patients developed grade 3 sensory neuropathy. Bortezomib plus Int-DAC proved tolerable at the highest dose tested. Lower CD74 expression was associated with CR/CRp (P = . 04) but not with disease-free or overall survival V体育ios版. .

Conclusion: The addition of bortezomib to standard 3 + 7 daunorubicin and cytarabine induction chemotherapy for AML resulted in an encouraging remission rate VSports最新版本. The maximum tested dose of bortezomib administered in combination with Int-DAC for remission consolidation was 1. 3 mg/m(2) and proved tolerable. Further testing of this regimen is planned. .

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Figures (V体育官网)

Fig 1.
Fig 1.
Flow chart indicating patient outcome, treatment-related deaths, and occurrence of grade 3 sensory neuropathy. Allo HCT, allogeneic hematopoietic cell transplantation; CR, complete remission; CRp, complete remission with incomplete platelet recovery; CVA, cerebral vascular accident; PR, partial response; SN, sensory neuropathy.
Fig 2.
Fig 2.
Survival plots and 95% CIs indicating (A) disease-free and (B) overall survival of patients treated in this study.

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