A phase 1b/2b multicenter study of oral panobinostat plus azacitidine in adults with MDS, CMML or AML with <= 30% blasts

作者：Garcia Manero G; Sekeres M A; Egyed M; Breccia M; Graux C; Cavenagh J D; Salman H; Illes A; Fenaux P; DeAngelo D J; Stauder R; Yee K; Zhu N; Lee J H; Valcarcel D; MacWhannell A; Borbenyi Z; Gazi L; Acharyya S; Ide S; Marker M; Ottmann O G^*

来源：Leukemia, 2017, 31(12): 2799-2806.

DOI：10.1038/leu.2017.159

Treatment with azacitidine (AZA), a demethylating agent, prolonged overall survival (OS) vs conventional care in patients with higher-risk myelodysplastic syndromes (MDS). As median survival with monotherapy is < 2 years, novel agents are needed to improve outcomes. This phase 1b/2b trial (n = 113) was designed to determine the maximum tolerated dose (MTD) or recommended phase 2 dose (RP2D) of panobinostat (PAN)+AZA (phase 1b) and evaluate the early efficacy and safety of PAN+AZA vs AZA monotherapy (phase 2b) in patients with higher-risk MDS, chronic myelomonocytic leukemia or oligoblastic acute myeloid leukemia with < 30% blasts. The MTD was not reached; the RP2D was PAN 30 mg plus AZA 75 mg/m(2). More patients receiving PAN +AZA achieved a composite complete response([CR)+morphologic CR with incomplete blood count+bone marrow CR (27.5% (95% CI, 14.6-43.9%)) vs AZA (14.3% (5.4-28.5%)). However, no significant difference was observed in the 1-year OS rate (PAN+AZA, 60% (50-80%); AZA, 70% (50-80%)) or time to progression (PAN+AZA, 70% (40-90%); AZA, 70% (40-80%)). More grade 3/4 adverse events (97.4 vs 81.0%) and on-treatment deaths (13.2 vs 4.8%) occurred with PAN+AZA. Further dose or schedule optimization may improve the risk/benefit profile of this regimen.

• 出版日期2017-12