Elacytarabine in relapsed/refractory acute myeloid leukaemia: an evaluation of clinical efficacy, pharmacokinetics, cardiac safety and effects on lipid profile

Leuk Res. 2014 Mar;38(3):346-51. doi: 10.1016/j.leukres.2013.12.011. Epub 2013 Dec 25.

Abstract

Elacytarabine is the elaidic acid ester derivative of cytarabine, designed to enter cells independently of nucleoside transporters. Effects of elacytarabine on QT interval, serum lipid profile and clinical activity were investigated in 43 relapsed/refractory AML patients. Mean maximum increase in corrected QT interval of 24( ± 29)ms occurred 48 h after elacytarabine infusion without associated arrhythmias or clinical symptoms. A non-clinically significant, elacytarabine exposure-dependent increase in cholesterol was caused by a cholesterol rich lipoprotein depleted of apolipoprotein B formed by infused phospholipids complexing cholesterol. Elacytarabine is clinically active in relapsed/refractory AML: overall response rate (CR + CRi) was 44% (16/36 with 7 non-evaluable patients) and adverse events were manageable. Clinical Trials.gov Identifier: NCT01258816.

Keywords: AML; Cardiac safety; Cholesterol; ECG; Elacytarabine; Lipoprotein; QT.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Agents / blood
  • Antineoplastic Agents / pharmacokinetics
  • Antineoplastic Agents / therapeutic use*
  • Cholesterol / blood*
  • Cytarabine / analogs & derivatives*
  • Cytarabine / blood
  • Cytarabine / pharmacokinetics
  • Cytarabine / therapeutic use
  • Drug Administration Schedule
  • Electrocardiography
  • Female
  • Heart / drug effects
  • Humans
  • Leukemia, Myeloid, Acute / blood
  • Leukemia, Myeloid, Acute / drug therapy*
  • Leukemia, Myeloid, Acute / physiopathology
  • Lipoproteins / blood*
  • Male
  • Middle Aged
  • Recurrence
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Lipoproteins
  • Cytarabine
  • 5'-oleoyl cytarabine
  • Cholesterol

Associated data

  • ClinicalTrials.gov/NCT01258816