A phase II open-label study of the intravenous administration of homoharringtonine in the treatment of myelodysplastic syndrome

Daver, Naval; Vega-Ruiz, Arturo; Kantarjian, Hagop M.; Estrov, Zeev; Ferrajoli, Alessandra; Kornblau, S.; Verstovšek, Srđan; Cortes, Jorge

doi:10.1111/ecc.12065

Cited by 14 publications

(13 citation statements)

References 31 publications

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“…The current study has demonstrated that cytogenetic and molecular abnormalities were able to affect AML induction therapy, RFS and OS, as well as being potential effective prognostic factors (41,42). In low-risk patients, the CR rates of the HCE and IA groups were 84.6 and 95.8%, respectively, and there was no significant difference between these groups.…”

Section: Discussionmentioning

confidence: 66%

Novel homobarringtonie‑containing therapy for the treatment of patients with primary acute myeloid leukemia that are resistant to conventional therapy

Zhu

et al. 2017

Oncol Lett

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Abstract. The current study investigated the efficacy and safety of a novel treatment regime consisting of homobarringtonie, cytosine arabinoside and etoposide (HCE) for the treatment of primary acute myeloid leukemia (AML). In the present study, 141 patients diagnosed with AML were divided into the HCE (n=47) and the conventional AML therapy, consisting of idamycin combined with cytarabine (IA; n=94), treatment groups. The measured patient outcome parameters were the emission and response rates, as well as medication-induced adverse events, with a median follow-up time of 28 months. There was no significant difference in the 3-year relapse-free survival rate between the HCE and IA treatment groups. The occurrence and severity of hematological or non-hematological toxicity did not differ between the two groups. However, of the 26 patients that demonstrated a poor response to the IA treatment, 19 cases were administered the HCE treatment and 14 of these patients achieved complete remission (CR). Of the 10 patients that demonstrated a poor response to the HCE treatment, 8 patients were administered the IA treatment and 7 of these achieved CR. Therefore, HCE may be an effective treatment regimen for patients with primary AML. As there was no cross-resistance between the HCE and IA regimens, HCE may be an alternative option for patients that respond poorly to IA induction therapy.

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Section: Discussionmentioning

confidence: 66%

Novel homobarringtonie‑containing therapy for the treatment of patients with primary acute myeloid leukemia that are resistant to conventional therapy

Zhu

et al. 2017

Oncol Lett

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Section: Discussionmentioning

confidence: 99%

“…HHT has also been administered to adults with MDS (7,12,(31)(32)(33). Daver et al (31) reported that the CR rate was 11% in patients with intermediate and high risk MDS, who received HHT alone. In addition, combination therapy of HHT and low-dose AraC has been demonstrated to be an effective strategy for advanced MDS and RAEBt and CR was observed in 46.9% (32); however, the median OS was shorter (18.2 months).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of homoharringtonine plus cytarabine and aclarubicin for patients with myelodysplastic syndrome-RAEB

Xiao

Liu

et al. 2015

Oncology Letters

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Abstract. The aim of the present study was to evaluate the treatment outcome of homoharringtonine, cytarabine (AraC) and aclarubicin combination therapy as induction treatment for myelodysplastic syndromes-refractory anemia with excess blasts (MDS-RAEB). A total of 24 patients with MDS-RAEB who were aged between 18 and 66 years were treated with homoharringtonine, AraC and aclarubicin (HAA regimen). The HAA regimen consisted of homoharringtonine (2 mg/m 2 intramuscularly twice daily, days 1-3), AraC (75 mg/m 2 injected subcutaneously twice daily, days 1-7) and aclarubicin (12 mg/m 2 , days 1-7). The overall response rate was 79% with a complete remission rate of 58.3% and partial remission rate of 20.7%. There was no evidence of early mortality in this group of patients. The median overall survival (OS) was 36.2 months (95% confidence interval, 24.6-47.4 months), and the estimated three year overall survival rate was 45.8%. In conclusion, HAA combination therapy is a suitable induction regimen for patients with MDS-RAEB, which may improve the outcome for de novo higher-risk MDS patients, particularly of those with favorable and intermediate cytogenetics.

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“…In another Phase II pilot study of HHT in myelodysplastic syndrome, HHT was given at a dose of 2.5 mg/m 2 via continuous infusion for 7 days and maintenance every 4 weeks. One patient (11%) responded with a CHR and cytogenetic remission after one course and eight patients did not respond 74. Similarly, the effect of omacetaxine mepesuccinate was tested in patients with acute myeloid leukemia.…”

Section: Efficacy Studiesmentioning

confidence: 99%

Omacetaxine mepesuccinate in the treatment of intractable chronic myeloid leukemia

Chen¹,

Li²

2014

OTT

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In a significant proportion of patients with chronic myeloid leukemia, resistance to BCR-ABL tyrosine kinase inhibitors develops due to acquisition of BCR-ABL kinase domain mutations and insensitivity of leukemia stem cells to tyrosine kinase inhibitors. Omacetaxine mepesuccinate (formerly called homoharringtonine) is a natural alkaloid that inhibits protein synthesis and induces cell death. Omacetaxine mepesuccinate has been recently approved by the US Food and Drug Administration to treat patients with chronic myeloid leukemia who failed to respond to multiple tyrosine kinase inhibitors and/or acquired the BCR-ABL-T315I mutation. In this review, we discuss the use and effectiveness of omacetaxine mepesuccinate in the treatment of chronic myeloid leukemia, with coverage of its pharmacology, mode of action, and pharmacokinetics. We believe that omacetaxine mepesuccinate will be beneficial to many patients with chronic myeloid leukemia who do not respond well to tyrosine kinase inhibitors.

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A phase II open-label study of the intravenous administration of homoharringtonine in the treatment of myelodysplastic syndrome

Cited by 14 publications

References 31 publications

Novel homobarringtonie‑containing therapy for the treatment of patients with primary acute myeloid leukemia that are resistant to conventional therapy

Novel homobarringtonie‑containing therapy for the treatment of patients with primary acute myeloid leukemia that are resistant to conventional therapy

Efficacy and safety of homoharringtonine plus cytarabine and aclarubicin for patients with myelodysplastic syndrome-RAEB

Omacetaxine mepesuccinate in the treatment of intractable chronic myeloid leukemia

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