Safety profile
Comparable safety to 7+3

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Common adverse reactions (≥20% incidence in the VYXEOS arm) during the induction phase
Adverse Reaction | All Gradesa | Grades 3 to 5a | ||
---|---|---|---|---|
VYXEOS (n=153) n (%) |
7+3 (n=151) n (%) |
VYXEOS (n=153) n (%) |
7+3 (n=151) n (%) |
|
Hemorrhage | 107 (70) | 74 (49) | 15 (10) | 9 (6) |
Febrile neutropenia | 104 (68) | 103 (68) | 101 (66) | 102 (68) |
Rash | 82 (54) | 55 (36) | 8 (5) | 2 (1) |
Edema | 78 (51) | 90 (60) | 2 (2) | 5 (3) |
Nausea | 72 (47) | 79 (52) | 1 (1) | 1 (1) |
Diarrhea/colitis | 69 (45) | 100 (66) | 4 (3) | 10 (7) |
Mucositis | 67 (44) | 69 (46) | 2 (1) | 7 (5) |
Constipation | 61 (40) | 57 (38) | 0 | 0 |
Musculoskeletal pain | 58 (38) | 52 (34) | 5 (3) | 4 (3) |
Abdominal pain | 51 (33) | 45 (30) | 3 (2) | 3 (2) |
Cough | 51 (33) | 34 (23) | 0 | 1 (1) |
Headache | 51 (33) | 36 (24) | 2 (1) | 1 (1) |
Dyspnea | 49 (32) | 51 (34) | 17 (11) | 15 (10) |
Fatigue | 49 (32) | 58 (38) | 8 (5) | 8 (5) |
Arrhythmia | 46 (30) | 41 (27) | 10 (7) | 7 (5) |
Decreased appetite | 44 (29) | 57 (38) | 2 (1) | 5 (3) |
Pneumonia (excluding fungal) | 39 (26) | 35 (23) | 30 (20) | 26 (17) |
Sleep disorders | 38 (25) | 42 (28) | 2 (1) | 1 (1) |
Bacteremia (excluding sepsis) | 37 (24) | 37 (25) | 35 (23) | 31 (21) |
Vomiting | 37 (24) | 33 (22) | 0 | 0 |
Chills | 35 (23) | 38 (25) | 0 | 0 |
Hypotension | 30 (20) | 32 (21) | 7 (5) | 1 (1) |
Non-conduction cardiotoxicity | 31 (20) | 27 (18) | 13 (9) | 15 (10) |
Fatal treatment-emergent CNS hemorrhage not in the setting of progressive disease occurred in 2% of patients in the VYXEOS arm and 0.7% in the control arm (7+3).
Other adverse reactions that occurred in ≥10% of patients in the VYXEOS arm included dizziness, fungal infection, hypertension, hypoxia, upper respiratory infections (excluding fungal), chest pain, pyrexia, catheter/device/injection site reaction, delirium, pleural effusion, anxiety, pruritus, sepsis (excluding fungal), hemorrhoids, petechiae, renal insufficiency, transfusion reactions, and visual impairment (except bleeding).
The safety population included all patients in the VYXEOS cohort and 151 patients from the 7+3 cohort (5 patients withdrew consent before the receipt of treatment).1
aAdverse reactions were graded using National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0.
Time to recovery of absolute neutrophil count and platelets may be prolonged with VYXEOS and require additional monitoring2
30- and 60-day overall all-cause mortality in patients with sAML aged 60-75 years (safety population)
A post hoc analysis was conducted to assess the impact of VYXEOS vs 7+3 on cardiac impairment in a subset of patients from the Phase 3 study.
Percentage of patients with clinically
significantc,d
change in LVEF or GLS3
Patients from the Phase 3 study (VYXEOS [n=57]; 7+3 [n=45]) with normal baseline LVEF and at least one postbaseline echocardiogram measure were evaluated. Patients with prior cumulative anthracycline exposure of
>368 mg/m2 daunorubicin (or equivalent) were excluded from the study.3
Cardiac function was assessed at3:
Median baseline LVEFc and GLSd in the VYXEOS and 7+3 arms were3:
Limitations of subanalysis3
The limitations of this analysis include its post hoc design, the restricted patient population, and limited follow-up time points. No conclusions should be drawn. Analysis was not powered to determine statistical significance.
VYXEOS treatment is not recommended in patients with LVEF that is less than normal. Discontinue VYXEOS in patients with impaired cardiac function unless the benefit of initiating or continuing treatment outweighs the risk.2
Some patients may be appropriate for outpatient administration of VYXEOS, giving you more options when planning their treatment. Read how some institutions are approaching outpatient use of VYXEOS.
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Secondary AML is a broad category of high-risk AML that includes multiple subtypes of leukemias with different characteristics but similar poor prognosis and significant challenge to reach a cure.5,6 Learn more about which patients may be appropriate for intensive chemotherapy with VYXEOS.
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References: 1. Lancet JE, Uy GL, Cortes JE, et al. CPX-351 (cytarabine and daunorubicin) liposome for injection versus conventional cytarabine plus daunorubicin in older patients with newly diagnosed secondary acute myeloid leukemia. J Clin Oncol. 2018;36(26):2684-2692.
2. VYXEOS [package insert]. Palo Alto, CA: Jazz Pharmaceuticals.
3. Mitchell JD, Pfeiffer M, Boehmer J, et al. P516: Cardiotoxicity of CPX-351 vs 7+3 in patients with untreated high-risk acute myeloid leukemia. Poster presented at: EHA2023 (European Hematology Association) Hybrid Congress; June 8–11, 2023; Frankfurt, Germany.
4. Mitchell JD, Pfeiffer M, Boehmer J, et al. P516: Cardiotoxivity of CPX-351 vs 7+3 in patients with untreated high-risk acute myeloid leukemia. Hemasphere. 2023;7(Suppl):e178806c.
5. Lalayanni C, Gavriilaki E, Athanasiadou A, et al. Secondary acute myeloid leukemia (sAML): similarly dismal outcomes of AML after an antecedent hematologic disorder and therapy related AML. Clin Lymphoma Myeloma Leuk. 2022;22(4):e233-e240.
6. Capelli D, Menotti D, Florentini A, Sarcani F, Olivieri A. Chapter 7: Secondary acute myeloid leukemia: pathogenesis and treatment. Accessed March 21, 2024. https://www.ncbi.nlm.nih.gov /books /NBK586211 /?report=printable