Impact of TP53 Mutation Status in Elderly AML Patients When Adding All-Trans Retinoic Acid or Valproic Acid to Decitabine.

TP53 AML ATRA HMA epigenetics

Journal

European journal of haematology
ISSN: 1600-0609
Titre abrégé: Eur J Haematol
Pays: England
ID NLM: 8703985

Informations de publication

Date de publication:
13 Oct 2024
Historique:
revised: 30 08 2024
received: 27 05 2024
accepted: 02 09 2024
medline: 14 10 2024
pubmed: 14 10 2024
entrez: 14 10 2024
Statut: aheadofprint

Résumé

In a randomized phase II trial (AMLSG 14-09, NCT00867672) of elderly, newly diagnosed AML patients, ATRA combined with decitabine (DEC) significantly improved the overall response rate (ORR) and survival also in patients with adverse-risk genetics, without adding toxicity. We performed a post hoc analysis to determine the predictive impact of TP53 status. Despite a nominally higher ORR, the clinically meaningful survival benefit when adding ATRA to DEC was diminished, but not completely negated, in TP53-mutated patients. Indeed, 2 out of 14 TP53-mutated patients (14%) randomized to a DEC + ATRA-containing regimen lived for > 36 months. Further studies of ATRA combined with hypomethylating agents appear warranted in non-M3 AML patients ineligible for HMA/venetoclax therapy. Trial Registration: ClinicalTrials.gov identifier: NCT00867672.

Identifiants

pubmed: 39400388
doi: 10.1111/ejh.14304
doi:

Banques de données

ClinicalTrials.gov
['NCT00867672']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The Author(s). European Journal of Haematology published by John Wiley & Sons Ltd.

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Auteurs

Helena Bresser (H)

Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Faculty of Medicine, Freiburg, Germany.

Claudia Schmoor (C)

Clinical Trials Unit, University Medical Center Freiburg, Freiburg, Germany.

Olga Grishina (O)

Clinical Trials Unit, University Medical Center Freiburg, Freiburg, Germany.

Dietmar Pfeifer (D)

Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Faculty of Medicine, Freiburg, Germany.

Johanna Thomas (J)

Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Faculty of Medicine, Freiburg, Germany.

Usama-Ur Rehman (UU)

Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Faculty of Medicine, Freiburg, Germany.

Martina Crysandt (M)

Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, University Hospital Aachen, Aachen, Germany.

Edgar Jost (E)

Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, University Hospital Aachen, Aachen, Germany.

Felicitas Thol (F)

Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.

Michael Heuser (M)

Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.

Katharina S Götze (KS)

Department of Medicine III, Technical University Munich School of Medicine, Klinikum Rechts der Isar, Munich, Germany.
German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Munich, Munich, Germany.

Richard F Schlenk (RF)

NCT-Trial Center, National Center of Tumor Diseases, Heidelberg, Germany.
German Cancer Research Center and Heidelberg University Hospital, Heidelberg, Germany.

Helmut R Salih (HR)

Department of Internal Medicine II, University Hospital Tübingen, Tübingen, Germany.

Marcus M Schittenhelm (MM)

Department of Internal Medicine II, University Hospital Tübingen, Tübingen, Germany.
Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Gerhard Heil (G)

Department of Hematology/Oncology, Klinikum Lüdenscheid, Lüdenscheid, Germany.

Carsten Schwaenen (C)

Department of Medical Oncology, Ortenau Hospital Offenburg, Offenburg, Germany.

Carsten Müller-Tidow (C)

NCT-Trial Center, National Center of Tumor Diseases, Heidelberg, Germany.
German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany.

Wolfram Brugger (W)

Hospital Villingen-Schwenningen, Planegg, Germany.

Andrea Kündgen (A)

Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Düsseldorf, Germany.
German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Düsseldorf, Düsseldorf, Germany.

Maike de Wit (M)

Department of Hematology, Oncology and Palliative Medicine, Vivantes Klinikum Neukoelln, Berlin, Germany.

Aristoteles Giagounidis (A)

Department of Oncology, Hematology and Palliative Care, Marienhospital Düsseldorf, Düsseldorf, Germany.

Sebastian Scholl (S)

Department of Internal Medicine II, University Hospital Jena, Jena, Germany.

Andreas Neubauer (A)

Klinik für Innere Medizin, Schwerpunkt Hämatologie, Onkologie und Immunologie, Philipps University, Marburg, Germany.

Jürgen Krauter (J)

Department of Internal Medicine III, Braunschweig Municipal Hospital, Braunschweig, Germany.

Gesine Bug (G)

Department of Medicine 2, Goethe University Frankfurt, Frankfurt, Germany.
German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Frankfurt, Frankfurt, Germany.

Annette M May (AM)

Institute of Pathology, University Freiburg, Freiburg, Germany.
Institute for Dermatohistology, Pathology, Molecular Pathology Prof. Dr. Helmut Laaff, Freiburg, Germany.

Ralph Wäsch (R)

Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Faculty of Medicine, Freiburg, Germany.

Justus Duyster (J)

Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Faculty of Medicine, Freiburg, Germany.
German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Freiburg, Freiburg, Germany.

Konstanze Döhner (K)

Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany.

Arnold Ganser (A)

Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.

Hartmut Döhner (H)

Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany.

Björn Hackanson (B)

Department of Hematology/Oncology, University Medical Center Augsburg, Augsburg, Germany.

Heiko Becker (H)

Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Faculty of Medicine, Freiburg, Germany.
German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Freiburg, Freiburg, Germany.

Michael Lübbert (M)

Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Faculty of Medicine, Freiburg, Germany.
German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Freiburg, Freiburg, Germany.

Classifications MeSH