Publication

Elacytarabine has single-agent activity in patients 
with advanced acute myeloid leukaemia

O'Brien, Susan
; 
Rizzieri, David A.
; 
Vey, Norbert
; 
Ravandi, Farhad
; 
Krug, Utz O.
; 
Sekeres, Mikkael A.
; 
Dennis, Mike
; 
Venditti, Adriano
; 
Berry, Donald A.
; 
Jacobsen, Tove Flem
... show 3 more
Identifiers
http://hdl.handle.net/10379/13169
 https://doi.org/10.13025/27179
Publication Date
2012-06-15
Keywords
elacytarabine, nucleoside analogue, lipid esterification, acute myelogenous leukemia, effective salvage regimen, fatty-acid derivatives, tumor-cell lines, g-csf, dose cytarabine, gemcitabine, cp-4055, expression, resistance
Type
Article
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Citation
O'Brien, Susan; Rizzieri, David A. Vey, Norbert; Ravandi, Farhad; Krug, Utz O.; Sekeres, Mikkael A.; Dennis, Mike; Venditti, Adriano; Berry, Donald A.; Jacobsen, Tove Flem; Staudacher, Karin; Bergeland, Trygve; Giles, Francis J. (2012). Elacytarabine has single-agent activity in patients 
with advanced acute myeloid leukaemia. British Journal of Haematology 158 (5), 581-588
Abstract
Elacytarabine is a novel cytotoxic nucleoside analogue, independent of nucleoside transporters (e.g. human Equilibrative Nucleoside Transporter 1 [hENT1]) for cell uptake, and mechanisms of action similar to those of cytarabine. This Phase II study assessed the efficacy and safety of elacytarabine in patients with advanced stage acute myeloid leukaemia (AML). Patients received 2000mg/m(2) per d continuously i.v. during days 15 every 3weeks. Patients were matched by six risk factors with historical controls; remission rate (assessed after 1 or 2 cycles) and 6-month survival were compared. Sixty-one patients, median age 58years, were enrolled; 52% had five or six risk factors. The remission rate was 18% (95% confidence interval: 9-30%) vs. 4% in controls (P<0.0001), 6-month survival rate was 43%, median overall survival was 5.3months (vs. 1.5months); 10 patients (16%) were referred for stem cell transplantation after treatment. Side effects were predictable and manageable. The most common grade 3/4 non-haematological adverse events were febrile neutropenia, hypokalemia, fatigue, hyponatraemia, dyspnoea and pyrexia. Thirty-day all-cause mortality, after start of treatment, was 13% vs. 25% in controls. Elacytarabine has monotherapy activity in patients with advanced AML. This study provides proof-of-concept that lipid esterification of nucleoside analogues is clinically relevant.
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Publisher
Wiley-Blackwell
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Attribution-NonCommercial-NoDerivs 3.0 Ireland
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Externally hosted open access publications with University of Galway authors (2)