151. SWOG0919: a Phase 2 study of idarubicin and cytarabine in combination with pravastatin for relapsed acute myeloid leukaemia.
- Author
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Advani, Anjali S., McDonough, Shannon, Copelan, Edward, Willman, Cheryl, Mulford, Deborah A., List, Alan F., Sekeres, Mikkael A., Othus, Megan, and Appelbaum, Frederick R.
- Subjects
ACUTE myeloid leukemia treatment ,IDARUBICIN ,CYTARABINE ,PRAVASTATIN ,CANCER relapse ,COMBINATION drug therapy ,CLINICAL trials ,THERAPEUTICS ,CANCER treatment - Abstract
Inhibition of cholesterol synthesis and uptake sensitizes acute myeloid leukaemia ( AML) blasts to chemotherapy. A Phase 1 study demonstrated the safety of high dose pravastatin given with idarubicin and cytarabine in patients with AML and also demonstrated an encouraging response rate. The Southwestern Oncology Group ( SWOG) trial, SWOG S0919, was a Phase 2 trial evaluating the complete remission ( CR) rate in a larger number of patients with relapsed AML treated with idarubicin, cytarabine and pravastatin. This study closed to accrual after meeting the defined criterion for a positive study. Thirty-six patients with a median age of 59 years (range 23-78) were enrolled. The median time from diagnosis to registration was 18 months. Relapse status was first relapse, 17 patients (47%); second relapse, 15 patients (42%); third relapse, two patients (5·5%) and fourth relapse, two patients (5·5%). The response rate was 75% [95% confidence interval: 58-88%; 20 CRs, 7 CR with incomplete count recovery ( CRi)], and the median overall survival was 12 months. The P-value comparing 75-30% (the null response rate based on prior SWOG experience) was 3·356 × 10
−4 . Given the encouraging CR/ CRi rate, this regimen should be considered for testing in a prospective randomized trial against best conventional therapy. [ABSTRACT FROM AUTHOR]- Published
- 2014
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