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Pediatric ALL regimen demonstrates solid results in AYA population
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SAN FRANCISCO — A pediatric regimen for the treatment of acute lymphoblastic leukemia yielded event-free survival rates of higher than 65% in a cohort of young adult patients, according to findings presented here.
Wendy Stock, MD, professor of Medicine and Hematology/Oncology and Director of the Leukemia Program at the University of Chicago School of Medicine, said that adolescent and young adult (AYA) patients have historically fared poorly with adult regimens, but that pediatric regimens in ALL have been enormously successful.
Wendy Stock
“We were asking the question of whether adult clinicians treating AYA patients could achieve the same results using pediatric protocols,” she said of the study’s objectives.
The regimen used in the current study was identical to that of the standard arm of the Children's Oncology Group regimen, or COG AALL0232.
EFS served as the primary outcome measure.
Eligible participants included newly diagnosed AYA patients with B-precursor or T-precursor ALL, while those with Burkitt type and Philadelphia-positive ALL were excluded.
There were 318 patients accrued between November 2007 and August 2012. The final analysis included 296 patients.
The median patient age at diagnosis was 25 years. “Most of these patients were in quite good shape when they started treatment,” Stock said.
Stock reported a 2-year EFS rate of 66%. “This is much better than what we have seen,” she said.
The 2-year OS was 79% to a median follow-up of about 3 years, according to Stock.
“This is a significant improvement over historical controls, which were about 34%,” Stock said, who added that longer follow-up is necessary.
Other findings indicated that patients with BCR-ABL1-like signature experienced poorer survival, and that CRLF2 was associated with worse EFS and OS.
Stock concluded that the pediatric regimen was successfully administered by clinicians who treat adults.
For more information:
Stock W. Abstract #796. Presented at: ASH Annual Meeting and Exhibition; Dec. 6-9, 2014; San Francisco.
Disclosure: Stock reports board member/advisory relationships with and has received research funding from Sigma Tau.