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VYXEOS demonstrated superior overall survival and higher HSCT rates vs 7+31,a

Discussion of the pivotal Phase 3 trial

Dr. Bayard Powell, section chief of Hematology and Oncology at Wake Forest Baptist Health, reviews the VYXEOS Phase 3 trial in detail and explains what the efficacy and safety data mean for adult sAML patients

Results of the Phase 3 trial were also published in the Journal of Clinical Oncology2

Overall survival

Kaplan-Meier curve for overall survival, ITT population1

Prespecified exploratory subgroup analysis of overall survival by age in the Phase 3 trial2

Limitations of subanalysis2

  • Results should be interpreted with caution, as this is an exploratory analysis of a specific subgroup

Patients receiving consolidation following successful induction had longer overall survival with VYXEOS vs those receiving 7+3/5+23,b

Outcomes in an exploratory post hoc analysis using data from the Phase 3 trial3

Limitations of subanalysis3

  • Results should be interpreted with caution, as this is an exploratory analysis of a specific subgroup
  • This analysis is potentially biased as it only includes responders who went on to receive consolidationc
  • The treatment effect of this nonrandomized subgroup is possibly confounded by unbalanced baseline characteristics

Complete remission

Percentage of patients who achieved CR1

Rate of hematopoietic stem cell transplant

Prespecified exploratory subgroup analysis of transplant rate by age in the Phase 3 trial5

Limitations of subanalysis5

  • Results should be interpreted with caution, as this is an exploratory analysis of a specific subgroup
  • This analysis was limited by the small patient number and that no statistical analysis was conducted on rate of HSCT by age group

Study design1

The Phase 3 study was a randomized, multicenter, open-label, active-controlled superiority study of VYXEOS versus cytarabine and daunorubicin (7+3) in patients 60 to 75 years of age with newly-diagnosed t-AML or AML-MRC. There were 153 patients randomized to VYXEOS and 156 patients randomized to the 7+3 arm. Twenty percent had t-AML, 54% had AML with an antecedent hematological disorder, and 25% had de novo AML with MDS-related cytogenetic abnormalities. Efficacy was established on the basis of overall survival from the date of randomization to death from any cause.

VYXEOS 44 mg/100 mg per m2 (daunorubicin/cytarabine) was given intravenously on Days 1, 3, and 5 for first induction and on Days 1 and 3 for those needing a second induction. For consolidation, the VYXEOS dose was 29 mg/65 mg per m2 (daunorubicin/cytarabine) on Days 1 and 3. In the 7+3 arm, first induction was cytarabine 100 mg/m2/day on Days 1-7 by continuous infusion + daunorubicin 60 mg/m2/day on Days 1-3. For second induction and consolidation, cytarabine was dosed on Days 1-5 and daunorubicin on Days 1 and 2. Patients could receive up to 2 cycles of induction and 2 cycles of consolidation in each arm. Subsequent induction was recommended for patients who did not achieve a response and was mandatory for patients achieving >50% reduction in percent blasts.

Learn more about the Phase 3 study design

INDICATION

VYXEOS (daunorubicin and cytarabine) liposome for injection 44 mg/100 mg is indicated for the treatment of adults with newly-diagnosed therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC).

IMPORTANT SAFETY INFORMATION

INDICATION

VYXEOS (daunorubicin and cytarabine) liposome for injection 44 mg/100 mg is indicated for the treatment of adults with newly-diagnosed therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC).

Important Safety Information

WARNING: DO NOT INTERCHANGE WITH OTHER DAUNORUBICIN AND/OR CYTARABINE-CONTAINING PRODUCTS

VYXEOS has different dosage recommendations than daunorubicin hydrochloride injection, cytarabine injection, daunorubicin citrate liposome injection, and cytarabine liposome injection. Verify drug name and dose prior to preparation and administration to avoid dosing errors.