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Improved Survival by Adding Lomustine to Conventional Chemotherapy for Elderly Patients With AML Without Unfavorable Cytogenetics: Results of the LAM-SA 2007 FILO Trial

dc.rights.licenseopenen_US
dc.contributor.authorPIGNEUX, Arnaud
dc.contributor.authorBENE, Marie C.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorSALMI, Louis Rachid
dc.contributor.authorDUMAS, Pierre-Yves
dc.contributor.authorDELAUNAY, Jacques
dc.contributor.authorBONMATI, Caroline
dc.contributor.authorGUIEZE, Romain
dc.contributor.authorLUQUET, Isabelle
dc.contributor.authorCORNILLET-LEFEBVRE, Pascale
dc.contributor.authorDELABESSE, Eric
dc.contributor.authorIANOTTO, Jean-Christophe
dc.contributor.authorOJEDA-URIBE, Mario
dc.contributor.authorHUNAULT-BERGER, Mathilde
dc.contributor.authorBANOS, Anne
dc.contributor.authorFORNECKER, Luc Matthieu
dc.contributor.authorBERNARD, Marc
dc.contributor.authorJOURDAN, Eric
dc.contributor.authorVEY, Norbert
dc.contributor.authorZERAZHI, Hacene
dc.contributor.authorHISHRI, Yosr
dc.contributor.authorMINEUR, Ariane
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorASSELINEAU, Julien
dc.contributor.authorDELEPINE, Roselyne
dc.contributor.authorCAHN, Jean-Yves
dc.contributor.authorIFRAH, Norbert
dc.contributor.authorRECHER, Christian
dc.date.accessioned2020-12-14T14:55:23Z
dc.date.available2020-12-14T14:55:23Z
dc.date.issued2018-09-27
dc.identifier.issn1527-7755 (Electronic) 0732-183X (Linking)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/21453
dc.description.abstractEnPURPOSE: Acute myeloid leukemia (AML) in elderly patients has a poor prognosis. In an attempt to improve outcome for these patients, the prospective open-label phase III LAM-SA 2007 (Adding Lomustine to Chemotherapy in Older Patients With Acute Myelogenous Leukemia (AML), and Allogeneic Transplantation for Patients From 60 to 65 Years Old) trial randomly assigned patients to a standard induction regimen with lomustine added or to a consolidation regimen with cytarabine and idarubicin. PATIENTS AND METHODS: Adults age 60 years or older with previously untreated AML who were fit to receive intensive chemotherapy and who were without unfavorable cytogenetics received standard chemotherapy with lomustine (idarubicin, cytarabine, and lomustine [ICL]) or without (idarubicin and cytarabine [IC]). The primary objective of the study was overall survival (OS); secondary objectives were response rate, cumulative incidence of relapse (CIR), event-free survival (EFS), and safety. RESULTS: From February 2008 to December 2011, 459 patients were enrolled. Comparing patients in the IC and ICL arms, complete response or complete response with incomplete recovery was achieved in 74.9% versus 84.7% ( P = .01). The proportional hazards assumption was rejected for OS ( P = .02), which led us to consider two separate time intervals: during and after induction. There was no significant difference between the two arms during induction, although induction deaths were 3.7% versus 7.7%, respectively ( P = .11). However, significantly better results were observed after induction with an improved 2-year OS of 56% in the ICL arm versus 48% in the IC arm ( P = .02). At 2 years, EFS was improved at 41% in the ICL arm versus 26% in the IC arm ( P = .01). The CIR at 2 years was 41.2% in the ICL arm versus 60.9% in the IC arm ( P = .003). Grade 3 and 4 toxicities, mostly hematologic, were significantly higher in the ICL arm ( P = .04), and fewer patients required a second treatment after ICL. CONCLUSION: Adding lomustine to standard chemotherapy significantly improved the outcome of elderly patients with AML.
dc.language.isoENen_US
dc.subject.enUSMR
dc.subject.enIETO
dc.title.enImproved Survival by Adding Lomustine to Conventional Chemotherapy for Elderly Patients With AML Without Unfavorable Cytogenetics: Results of the LAM-SA 2007 FILO Trial
dc.title.alternativeJ Clin Oncolen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1200/jco.2018.78.7366en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed30260758en_US
bordeaux.journalJournal of clinical oncologyen_US
bordeaux.pageJco2018787366en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - U1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.teamUSMRen_US
bordeaux.teamIETOen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.exportfalse
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