Finding the Optimal Combination Therapy for the Treatment of Newly Diagnosed AML in Older Patients Unfit for Intensive Therapy

Leuk Res. 2015 Feb;39(2):183-91. doi: 10.1016/j.leukres.2014.11.027. Epub 2014 Dec 9.

Abstract

There is no standard of care for older patients with newly diagnosed acute myeloid leukemia (AML) unfit for intensive therapy, and prognosis with currently recommended low-intensity therapies (decitabine, azacitidine, and low-dose cytarabine [LDAC]) remains poor. One promising strategy is to combine low-intensity treatments with novel agents. Gemtuzumab ozogamicin, tipifarnib, and barasertib have been investigated in phase 2/3 or 3 trials combined with LDAC, and phase 3 trials are currently investigating sapacitabine plus decitabine, and volasertib plus LDAC in AML. This review discusses current treatment recommendations and the development of combination therapies for older patients unfit for intensive therapy.

Keywords: Acute myeloid leukemia (AML); Combination; Low-intensity; Newly diagnosed; Novel agents; Older/elderly.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aminoglycosides / administration & dosage
  • Aminoglycosides / adverse effects
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Azacitidine / administration & dosage
  • Azacitidine / adverse effects
  • Azacitidine / analogs & derivatives
  • Clinical Trials, Phase II as Topic
  • Clinical Trials, Phase III as Topic
  • Critical Care
  • Cytarabine / administration & dosage
  • Cytarabine / adverse effects
  • Decitabine
  • Female
  • Gemtuzumab
  • Humans
  • Leukemia, Myeloid, Acute / drug therapy*
  • Male
  • Organophosphates / administration & dosage
  • Organophosphates / adverse effects
  • Quinazolines / administration & dosage
  • Quinazolines / adverse effects
  • Quinolones / administration & dosage
  • Quinolones / adverse effects

Substances

  • 2-((3-((4-((5-(2-((3-fluorophenyl)amino)-2-oxoethyl)-1H-pyrazol-3-yl)amino)quinazolin-7-yl)oxy)propyl)(ethyl)amino)ethyl dihydrogen phosphate
  • Aminoglycosides
  • Antibodies, Monoclonal, Humanized
  • Organophosphates
  • Quinazolines
  • Quinolones
  • Cytarabine
  • Decitabine
  • Gemtuzumab
  • Azacitidine
  • tipifarnib