Do Baseline Blast Percentages Impact Survival Outcomes with CPX-351 in AML?

Jorge Cortes, MD, of the Georgia Cancer Center at Augusta University, speaks about a five-year follow-up study of survival outcomes with CPX-351 versus 7+3 by baseline bone marrow blast percentage in older adults with newly diagnosed high-risk or secondary acute myeloid leukemia (AML).

Dr. Cortes and colleagues presented the research during the 2023 American Society of Clinical Oncology Annual Meeting.

CPX-351, a dual-drug liposomal encapsulation of daunorubicin and cytarabine in a 1:5 molar ratio, is approved for newly diagnosed therapy-related AML or AML with myelodysplasia-related changes in the United States and Europe. Its approval followed positive efficacy and safety data from a pivotal phase III clinical trial.

Dr. Cortes and colleagues evaluated the longer-term efficacy and safety of the therapy across bone marrow blast percentage subgroups in the follow-up analysis.

“We know that the percentage of blasts sometimes has been suggested to have prognostic implications,” he said.

Dr. Cortes and colleagues wanted to investigate if the benefit of the therapy applies across subgroups, or if it was primarily driven by those with higher or lower bone marrow blast percentages.

“That was the genesis of these analyses,” he said.

Dr. Cortes and colleagues found that the median overall survival (OS) and event-free survival were longer with CPX-351 than 7+3 across bone marrow blast percentage subgroups. However, for both treatments, the median OS was highest in patients with low baseline bone marrow blast percentages.

Overall, the five-year follow-up data suggested that CPX-351 results in “improved outcomes irrespective” of baseline bone marrow blast percentage compared with conventional 7+3 chemotherapy in older adults with AML.