Hotinski Anya K, Lewis Ian D, Ross David M
Royal Adelaide Hospital, Leukaemia Fellow, SA Pathology , Adelaide, SA 5000 , Australia.
Expert Opin Pharmacother. 2015 Jun;16(9):1395-402. doi: 10.1517/14656566.2015.1044437. Epub 2015 May 10.
Vosaroxin is a first-in-class anti-cancer quinolone that inhibits topoisomerase-II leading to cell cycle arrest and apoptosis. It has shown efficacy in a range of solid organ and haematopoietic tumours in vitro, and several clinical trials are underway or completed in the field of Acute Myeloid Leukaemia (AML). The treatment of relapsed and refractory AML is a clinical challenge, where long-term survival is rare without allogeneic haematopoietic stem cell transplantation.
We review the data from the published clinical trials of vosaroxin, including the recently presented Phase III VALOR study. In combination with intermediate dose cytarabine, vosaroxin almost doubled complete response (CR) rates in relapsed and refractory AML compared with cytarabine alone, and prolonged median survival by 1.4 months.
Vosaroxin is a promising new agent in the treatment of AML, with the potential to improve CR rates in a high-risk group of patients with relapsed and refractory AML. However, higher CR rates have been associated with higher rates of treatment-related morbidity and mortality, especially in elderly/unfit patients. Maximising the potential of vosaroxin will therefore require the identification of patients most likely to benefit from vosaroxin-containing combination regimens.
伏沙洛辛是一种首创的抗癌喹诺酮类药物，可抑制拓扑异构酶-II，导致细胞周期停滞和细胞凋亡。它在体外对一系列实体器官肿瘤和造血系统肿瘤均显示出疗效，并且在急性髓系白血病（AML）领域正在进行或已完成多项临床试验。复发和难治性AML的治疗是一项临床挑战，若无异基因造血干细胞移植，长期生存极为罕见。
我们回顾了伏沙洛辛已发表的临床试验数据，包括最近公布的III期VALOR研究。与中等剂量阿糖胞苷联合使用时，伏沙洛辛相比单独使用阿糖胞苷，使复发和难治性AML的完全缓解（CR）率几乎翻倍，并使中位生存期延长了1.4个月。
伏沙洛辛是治疗AML的一种有前景的新药，有可能提高复发和难治性AML高危患者群体的CR率。然而，较高的CR率与较高的治疗相关发病率和死亡率相关，尤其是在老年/身体状况不佳的患者中。因此，要充分发挥伏沙洛辛的潜力，需要确定最有可能从含伏沙洛辛的联合治疗方案中获益的患者。
