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一项阿扎胞苷和吉妥珠单抗奥佐米星联合治疗老年急性髓系白血病的 2 期临床试验。

A phase 2 trial of azacitidine and gemtuzumab ozogamicin therapy in older patients with acute myeloid leukemia.

机构信息

Department of Medicine, Loyola University Medical Center, Maywood, IL;

出版信息

Blood. 2013 Nov 14;122(20):3432-9. doi: 10.1182/blood-2013-06-506592. Epub 2013 Oct 3.

Abstract

This trial tested the safety and efficacy of a regimen consisting of hydroxyurea followed by azacitidine, 75 mg/m(2) for 7 days, and gemtuzumab ozogamicin, 3 mg/m(2) on day 8, in older patients with newly diagnosed acute myeloid leukemia. Those achieving a complete remission received 1 consolidation treatment followed by 4 cycles of azacitidine. The patients were stratified into good-risk (age 60-69 years or performance status 0-1) and poor-risk (age ≥70 years and performance status 2 or 3) groups. Specific efficacy and safety goals were defined as being supportive of further study of the regimen. Eighty-three patients were registered in the good-risk cohort and 59 in poor-risk cohort, with median age of 71 and 75 years, respectively. In the good-risk group, 35 patients (44%) achieved a complete remission. Median relapse-free and overall survivals were 8 and 11 months, respectively. Six patients (8%) died within 30 days of registration. In the poor-risk group, 19 (35%) achieved a complete remission. Median relapse-free and overall survivals were 7 and 11 months, respectively. Seven patients (14%) died early. The results of this trial met predefined goals for efficacy and safety for the poor-risk cohort but not the good-risk group. .

摘要

这项试验旨在测试羟基脲联合阿扎胞苷(75mg/m2,连用 7 天)和吉妥珠单抗奥佐米星(3mg/m2,第 8 天)方案在新诊断的老年急性髓系白血病患者中的安全性和疗效。完全缓解的患者接受 1 次巩固治疗,随后接受 4 个周期的阿扎胞苷治疗。患者分为低危组(年龄 60-69 岁或体能状态 0-1 分)和高危组(年龄≥70 岁和体能状态 2 或 3 分)。具体的疗效和安全性目标是支持进一步研究该方案。83 例患者入组低危组,59 例患者入组高危组,中位年龄分别为 71 岁和 75 岁。在低危组中,35 例患者(44%)达到完全缓解。中位无复发生存期和总生存期分别为 8 个月和 11 个月。6 例患者(8%)在注册后 30 天内死亡。在高危组中,19 例患者(35%)达到完全缓解。中位无复发生存期和总生存期分别为 7 个月和 11 个月。7 例患者(14%)早期死亡。该试验的结果达到了高危组疗效和安全性的预设目标,但未达到低危组的目标。

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