With the first collaborative, multidrug trial in a blood cancer, The Leukemia & Lymphoma Society aims to dramatically alter the 40-year-old diagnosis and treatment paradigm in first-line acute myelogenous leukemia, and to create a virtuous cycle of identifying new driver mutations that can be matched to targeted agents.
The standard of care in first-line AML consists of four to six cycles of anthracycline-based chemotherapy plus cytarabine. The drugs are started together. Anthracycline is given for the first three days and cytarabine for a full seven days. The regimen, commonly called “seven plus three,” has been in use since the early 1970s.
Once patients are in remission, they undergo consolidation chemotherapy and may receive a stem cell transplant.
Genomic analysis is used for prognostic purposes and to identify candidates for stem cell transplants, but not to choose drug therapy given lack of approved targeted agents for newly diagnosed patients.
In the over-60 population, who constitute the majority of newly diagnosed patients with AML, many cannot tolerate the intense chemotherapy cycles, resulting in a five-year survival rate in this population of about 10%, according to LLS.
LLS hopes to change this.
“A one-size fits-all approach doesn’t