<生醫新聞>Cyclacel臨床三期的急性骨髓性白血病藥物在關鍵研究中失敗
#AcuteMyeloidLeukemia #FailedTrials #ClinicalResearch #Cyclacel #Decitabine #Sapacitabine #FDA
Cyclacel Pharmaceuticals has been taught the meaning of futility. Two years after an independent data monitoring board told Cyclacel its phase 3 acute myeloid leukemia (AML) trial was destined to fail, the ever-optimistic biotech has reported its drug sapacitabine was unable to better the active control in terms of overall survival.
The top-line data confirm an outcome that looked likely from the minute independent advisers told Cyclacel the study had failed an interim futility review in December 2014. By then, the phase 3 trial had chalked up 247 of the 424 patient deaths needed to trigger the end of the study. But, with the review finding no safety issues that would force Cyclacel to shutter the study, the NJ-based biotech pushed ahead regardless.
A little more than two years later, Cyclacel has learnt sapacitabine is no better at improving overall survival in elderly patients with AML than decitabine, an Otsuka drug FDA rejected in the indication in 2012 on the basis that it also failed to outperform the control arm in its own study. Decitabine, sold under the name Dacogen as a treatment for myelodysplastic syndromes, is used off-label in elderly AML patients because of the dearth of options in this population.
When combined with the performance of sapacitabine against some secondary endpoints, the lack of options for elderly patients with AML who cannot or will not undergo chemotherapy has given Cyclacel encouragement to continue seeking a way forward for the drug.
“We plan to discuss the data with European and U.S. regulatory authorities once subgroup analyses are completed over the next few months and will report our further plans as they develop,” CEO Spiro Rombotis said in a statement.
Rombotis and the chair of the phase 3, MD Anderson’s Hagop Kantarjian M.D., picked out the data on complete remission and safety as cause for optimism. Kantarjian, a critic of FDA’s decision to reject decitabine in AML, called the improved rate of complete remission “remarkable.” Cyclacel said the safety of the two arms was similar.
While Rombotis and Kantarjian see the data as suggesting it is still too early to write off sapacitabine, investors were less optimistic. Cyclacel dropped 30% in premarket trading, adding further woes to a stock that is down 99% on the highs it hit a decade ago. The company’s market cap prior to news of the latest setback stood at $24 million.
資料來源:http://www.fiercebiotech.com/…/cyclacel-aml-drug-fails-phas…
同時也有2部Youtube影片,追蹤數超過3萬的網紅[email protected],也在其Youtube影片中提到,慢性骨髓性白血病不是絕症?- 陳敏航血液及血液腫瘤科專科醫生@FindDoc.com FindDoc Facebook : https://www.facebook.com/FindDoc FindDoc WeChat : 快徳健康香港 FindDoc FindDoc Instagram:@...
aml treatment 在 [email protected] Youtube 的最佳解答
慢性骨髓性白血病不是絕症?- 陳敏航血液及血液腫瘤科專科醫生@FindDoc.com
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(一)慢性骨髓性白血病有什麼治療方法? 00:06
(二)慢性骨髓性白血病是不是“絕症”? 00:31
(三)TKI能使慢性骨髓性白血病痊愈嗎? 01:24
(四)病人是否要一直服藥來控制病情,不能停藥? 02:10
(五) 醫生對慢性骨髓性白血病有什麼建議? 03:12
(本短片作健康教育之用,並不可取代任何醫療診斷或治療。治療成效因人而異,如有疑問,請向專業醫療人士諮詢。)
參考資料:
1. Falchi, L., Kantarjian, H. M., Wang, X., Verma, D., Quintás-Cardama, A., O'Brien, S., … Cortes, J. E. (2013). Significance of deeper molecular responses in patients with chronic myeloid leukemia in early chronic phase treated with tyrosine kinase inhibitors. American journal of hematology, 88(12), 1024–1029. doi:10.1002/ajh.23560
2. Cortes JE, Saglio G, Kantarjian HM, et al. Final 5-year study results of DASISION: the dasatinib versus imatainib study in treatment-nviae chronic myeloid leukemia patients trial. J Clin Oncol 2016;34:2333-2340
3. Hochhaus A, Saglio G, Hughes TP, et al. Long-term benefits and risks of Goldberg, S. L., Savona, M., & Mauro, M. J. (2018). Considerations for Successful Treatment-free Remission in Chronic Myeloid Leukemia. Clinical Lymphoma Myeloma and Leukemia, 18(2), 98-105. doi:10.1016/j.clml.2017.11.006 frontline nilotinib vs imatinib for chronic myeloid leukemia in chronic phase: 5 year update of the randomized ENESTnd trial. Leukemia 2016;30:1044-1054
4. Stem Cell Transplant for Chronic Myeloid Leukemia. (n.d.). Retrieved from https://www.cancer.org/cancer/chronic-myeloid-leukemia/treating/bone-marrow-stem-cell.html
5. Talpaz, M., Mercer, J., & Hehlmann, R. (2015). The interferon-alpha revival in CML. Annals of Hematology, 94(Supplement 2), 195-207.
6. Bower, H., Björkholm, M., Dickman, P. W., Höglund, M., Lambert, P. C., & Andersson, T. M. (2016). Life Expectancy of Patients With Chronic Myeloid Leukemia Approaches the Life Expectancy of the General Population. Journal of Clinical Oncology, 34(24), 2851-2857. doi:10.1200/jco.2015.66.2866
7. Timothy P. Hughes, Carla Boquimpani, Naoto Takahashi, et al.(2018). ENESTop 144-Week Update: Long-Term Treatment-Free Remission (TFR) in Patients with Chronic Myeloid Leukemia in Chronic Phase (CML-CP) After Stopping Second-Line Nilotinib, 18, S222. doi:https://doi.org/10.1016/j.clml.2018.07.092
8. Francis J. Giles, Tamas Masszi, María Teresa Gómez Casares, et al. (2019). Treatment-free remission (TFR) following frontline (1L) nilotinib (NIL) in patients (pts) with chronic myeloid leukemia in chronic phase (CML-CP): 192-week data from the ENESTfreedom study. Journal of Clinical Oncology 2019 37:15_suppl, 7013-7013
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Currently inpatient for AML* treatment. Nonetheless, good mood drove activity....or the other way around.
*Acute Myeloid Leukemia
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