Dr. Wetzler Discusses the Use of Arsenic Trioxide in APL
Meir Wetzler, MD
Published Online: Tuesday, March 26, 2013
Meir Wetzler, MD, Chief, Leukemia Section, Department of Medicine, Roswell Park Cancer Institute, discusses a study presented at the 2012 American Society of Hematology Meeting analyzing arsenic trioxide in acute promyelocytic leukemia (APL).
Wetzler notes that APL was a deadly disease until ATRA came along in the 1970s. Since then, it has been used with chemotherapy to improve survival.
The phase III trial APL0406 trial looked at all trans-retinoic acid (ATRA) and arsenic trioxide compared to ATRA and idarubicin for newly diagnosed patients with non high-risk APL.
In this trial, after a median follow-up of 31 months, the two-year event-free survival was 97% (95% CI, 93.1–100) in the ATRA + arsenic trioxide arm and 86.7% (95% CI, 80.3–93.6) in the ATRA + idarubicin arm (P = 0.03). In this population, front-line treatment with arsenic trioxide and ATRA without chemotherapy is not inferior.
Ruxolitinib, a JAK1/2 inhibitor, is the first treatment to demonstrate efficacy in a phase III trial for patients with polycythemia vera (PV), a chronic, incurable blood cancer with limited treatment options