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

Susan O'Brien*, David A. Rizzieri, Norbert Vey, Farhad Ravandi, Utz O. Krug, Mikkael A. Sekeres, Mike Dennis, Adriano Venditti, Donald A. Berry, Tove Flem Jacobsen, Karin Staudacher, Trygve Bergeland, Francis J. Giles

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

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 2000 mg/m 2 per d continuously i.v. during days 1-5 every 3 weeks. 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 58 years, 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 5·3 months (vs. 1·5 months); 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.

Original languageEnglish (US)
Pages (from-to)581-588
Number of pages8
JournalBritish Journal of Haematology
Volume158
Issue number5
DOIs
StatePublished - Sep 2012

Keywords

  • Elacytarabine
  • Lipid esterification
  • Nucleoside analogue

ASJC Scopus subject areas

  • Hematology

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