A randomised evaluation of low-dose cytosine arabinoside plus lenalidomide versus single-agent low-dose cytosine arabinoside in older patients with acute myeloid leukaemia: Results from the LI-1 trial

Br J Haematol. 2024 Mar;204(3):871-876. doi: 10.1111/bjh.19220. Epub 2023 Nov 28.

Abstract

Improving outcomes for older patients with acute myeloid leukaemia remains an unmet need. As part of the LI-1 trial, we evaluated lenalidomide (LEN) in combination with low-dose cytosine arabinoside (LDAC) in patients aged >60 years unfit for intensive therapy and compared this to LDAC alone. Two hundred and two patients, randomised 1:1, were evaluable. Overall response rate (CR + CRi) was higher for LDAC + LEN versus LDAC (26% and 13.7% respectively p = 0.031). However, there was no difference in overall survival between the arms (14% and 11.5% at 2 years for LDAC + LEN and LDAC respectively). The addition of LEN was associated with increased toxicity and supportive care requirements.

Keywords: acute myeloid leukaemia; clinical trial; elderly; lenalidomide; low-dose cytosine arabinoside.

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cytarabine*
  • Humans
  • Lenalidomide / therapeutic use
  • Leukemia, Myeloid, Acute* / drug therapy
  • Remission Induction

Substances

  • Cytarabine
  • Lenalidomide