Clinical Trial Outcomes Mahdi, Mahdi & Knapper Chemotherapeutic treatment of acute myeloid leukemia 5 Clinical Trial Outcomes Chemotherapeutic treatment of acute myeloid leukemia: incorporating the results of recent clinical trials Clin. Invest. (Lond.) Better outcomes for patients with acute myeloid leukemia over the last 30 years have Ali J Mahdi*,1, Eamon J been largely achieved by improvements in supportive care measures rather than Mahdi1 & Steven Knapper1 therapeutic advances. The combination of daunorubicin and cytarabine has remained 1Cardiff University School of Medicine, Hematology Department, Heath Park, the standard of care for patients undergoing intensive induction–consolidation Cardiff CF14 4XN, UK treatment. In less fit older patients, low-dose cytarabine is the equivalent, although *Author for correspondence: the hypomethylating agent azacitidine may be challenging current practice.
[email protected] Enhanced understanding of disease pathogenesis and therapy resistance has enabled the entry of novel chemotherapeutic and nonchemotherapeutic agents into clinical development with varied levels of activity. This article examines the evidence behind established chemotherapy practices for intensive and nonintensive acute myeloid leukemia treatments with an emphasis on emerging clinical trial data from novel chemotherapeutic and nonchemotherapeutic agents. Keywords: acute myeloid leukemia • aminopeptidase inhibitors • farnesyl transferase inhibitors • FLT3 inhibitors • gemtuzumab ozogamicin • histone deacytylase inhibitors • hypomethylating • Polo-like kinase 1 inhibitors Methodology AML cases [7]. Older patients over the age of 10.4155/CLI.14.112 An electronic database search (EMBASE, 60 years thus represent an important popula- MEDLINE and PubMed) was undertaken tion from both demographic and therapeutic to identify and review clinical studies in perspectives. Older patients frequently have acute myeloid leukemia (AML) undertaken multiple comorbidities, unfavorable cyto- between 1 January 2009 and 1 June 2014.