A phase 1/2 study of NS-87/CPX-351 (cytarabine and daunorubicin liposome) in Japanese patients with high-risk acute myeloid leukemia

Int J Hematol. 2024 Jun;119(6):647-659. doi: 10.1007/s12185-024-03733-z. Epub 2024 Mar 26.

Abstract

Objectives: NS-87/CPX-351 is a dual-drug liposomal encapsulation of cytarabine and daunorubicin. NS-87/CPX-351 exerts antileukemic action by maintaining a synergistic molar ratio of cytarabine to daunorubicin of 5:1 within the liposome while in circulation. Patients with high-risk acute myeloid leukemia (AML), which includes therapy-related AML and AML with myelodysplasia-related changes (AML-MRC), have poorer outcomes than those with other AML.

Methodology: This open-label phase 1/2 (P1/2) study was conducted in 47 Japanese patients aged 60-75 years with newly diagnosed high-risk AML to evaluate the pharmacokinetics, safety, and efficacy of NS-87/CPX-351.

Results: In the 6 patients enrolled in the P1 portion, no dose-limiting toxicities (DLTs) were reported, and 100 units/m2 during the induction cycle was found to be acceptable. Cytarabine and daunorubicin had a long half-life in the terminal phase (32.8 and 28.7 h, respectively). In the 35 patients enrolled in the P2 portion, composite complete remission (CRc; defined as complete remission [CR] or CR with incomplete hematologic recovery [CRi]) was achieved in 60.0% (90% CI: 44.7-74.0) of the patients. Adverse events due to NS-87/CPX-351 were well tolerated.

Outcomes: NS-87/CPX-351 can be considered as a frontline treatment option for Japanese patients with high-risk AML.

Keywords: Acute myeloid leukemia; CPX-351; Cytarabine; Daunorubicin; Liposomal formulation.

Publication types

  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Multicenter Study

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols* / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols* / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols* / pharmacokinetics
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Asian People
  • Cytarabine* / administration & dosage
  • Cytarabine* / pharmacokinetics
  • Daunorubicin* / administration & dosage
  • Daunorubicin* / pharmacokinetics
  • East Asian People
  • Female
  • Humans
  • Japan
  • Leukemia, Myeloid, Acute* / drug therapy
  • Liposomes*
  • Male
  • Middle Aged
  • Treatment Outcome

Substances

  • Daunorubicin
  • Cytarabine
  • Liposomes
  • CPX-351