1. Decitabine and vorinostat with FLAG chemotherapy in pediatric relapsed/refractory AML: Report from the therapeutic advances in childhood leukemia and lymphoma (TACL) consortium
- Author
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Pommert, Lauren, Schafer, Eric S, Malvar, Jemily, Gossai, Nathan, Florendo, Ellynore, Pulakanti, Kirthi, Heimbruch, Katelyn, Stelloh, Cary, Chi, Yueh‐Yun, Sposto, Richard, Rao, Sridhar, Huynh, Van Thu, Brown, Patrick, Chang, Bill H, Colace, Susan I, Hermiston, Michelle L, Heym, Kenneth, Hutchinson, Raymond J, Kaplan, Joel A, Mody, Rajen, O'Brien, Tracey A, Place, Andrew E, Shaw, Peter H, Ziegler, David S, Wayne, Alan, Bhojwani, Deepa, and Burke, Michael J
- Subjects
Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Oncology and Carcinogenesis ,Stem Cell Research ,Clinical Trials and Supportive Activities ,Stem Cell Research - Nonembryonic - Human ,Cancer ,Pediatric ,Minority Health ,Orphan Drug ,Hematology ,Childhood Leukemia ,Clinical Research ,Rare Diseases ,Transplantation ,Genetics ,Pediatric Cancer ,6.1 Pharmaceuticals ,6.2 Cellular and gene therapies ,Antineoplastic Combined Chemotherapy Protocols ,Child ,Cytarabine ,Decitabine ,Humans ,Leukemia ,Myeloid ,Acute ,Lymphoma ,Vorinostat ,Cardiorespiratory Medicine and Haematology ,Immunology ,Cardiovascular medicine and haematology - Abstract
Survival outcomes for relapsed/refractory pediatric acute myeloid leukemia (R/R AML) remain dismal. Epigenetic changes can result in gene expression alterations which are thought to contribute to both leukemogenesis and chemotherapy resistance. We report results from a phase I trial with a dose expansion cohort investigating decitabine and vorinostat in combination with fludarabine, cytarabine, and G-CSF (FLAG) in pediatric patients with R/R AML [NCT02412475]. Thirty-seven patients enrolled with a median age at enrollment of 8.4 (range, 1-20) years. There were no dose limiting toxicities among the enrolled patients, including two patients with Down syndrome. The recommended phase 2 dose of decitabine in combination with vorinostat and FLAG was 10 mg/m2 . The expanded cohort design allowed for an efficacy evaluation and the overall response rate among 35 evaluable patients was 54% (16 complete response (CR) and 3 complete response with incomplete hematologic recovery (CRi)). Ninety percent of responders achieved minimal residual disease (MRD) negativity (
- Published
- 2022