Tamibarotene maintenance improved relapse-free survival of acute promyelocytic leukemia: a final result of prospective, randomized, JALSG-APL204 study

Takeshita, Akira; Asou, Norio; Atsuta, Yoshiko; Sakura, Toru; Ueda, Yasunori; Sawa, Masashi; Dobashi, Nobuaki; Taniguchi, Yasuhiro; Suzuki, Rikio; Nakagawa, Masaru; Tamaki, Shigehisa; Hagihara, Maki; Fujimaki, Katsumichi; Furumaki, Hiroaki; Obata, Yukako; Fujita, Hiroyuki; Yanada, Masamitsu; Maeda, Yoshinobu; Usui, Noriko; Kobayashi, Yukio; Kiyoi, Hitoshi; Ohtake, Shigeki; Matsumura, Itaru; Naoe, Tomoki; Miyazaki, Yasushi

doi:10.1038/s41375-018-0233-7

Cited by 30 publications

(32 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent randomized study of the Japanese Adult Leukemia Study Group has demonstrated a significant benefit in relapse-free survival of tamibarotene over ATRA in maintenance therapy, especially in high-risk patients who obtained molecular remission with ATRA and chemotherapy. 47 Given the extreme rarity of relapse in low-risk patients who are PCR 2 after completion of consolidation, the panel concluded that there was no need for blood or marrow PCR monitoring after this time in these patients.…”

Section: Management After Consolidationmentioning

confidence: 99%

Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet

Sanz

Fenaux

Tallman

et al. 2019

Blood

Self Cite

448

View full text Add to dashboard Cite

Since the comprehensive recommendations for the management of acute promyelocytic leukemia (APL) reported in 2009, several studies have provided important insights, particularly regarding the role of arsenic trioxide (ATO) in frontline therapy. Ten years later, a European LeukemiaNet expert panel has reviewed the recent advances in the management of APL in both frontline and relapse settings in order to develop updated evidence- and expert opinion–based recommendations on the management of this disease. Together with providing current indications on genetic diagnosis, modern risk-adapted frontline therapy, and salvage treatment, the review contains specific recommendations for the identification and management of the most important complications such as the bleeding disorder APL differentiation syndrome, QT prolongation, and other all-trans retinoic acid– and ATO-related toxicities, as well as recommendations for molecular assessment of the response to treatment. Finally, the approach to special situations is also discussed, including management of APL in children, elderly patients, and pregnant women. The most important challenges remaining in APL include early death, which still occurs before and during induction therapy, and optimizing treatment in patients with high-risk disease.

show abstract

Section: Management After Consolidationmentioning

confidence: 99%

Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet

Sanz

Fenaux

Tallman

et al. 2019

Blood

Self Cite

448

View full text Add to dashboard Cite

show abstract

“…A new synthetic retinoid Tamibarotene (Am80) with higher binding affinity to PML-RARA than ATRA has been under investigation. Tamibarotene is a potent inducer of differentiation in HL-60 and NB-4 cell lines in vitro; the synthetic retinoid has also shown a longer half-life when compared to ATRA [69]. Clinical studies have shown a modest effect in relapsed patients; however, statistical differences in efficacy seem to vanish at 5 years [69].…”

Section: Treatment Complications Of Aplmentioning

confidence: 99%

Acute promyelocytic leukemia (APL): a review of the literature

et al. 2020

View full text Add to dashboard Cite

Acute Promyelocytic Leukemia (APL) is characterized by a block in differentiation where leukemic cells are halted at the promyelocyte stage. A characteristic balanced chromosomal translocation between chromosomes 15 and 17 t (15;17) (q24; q21) is seen in 95% of cases-the translocation results in the formation of the PML-RARA fusion protein. The introduction of retinoic acid (RA) and arsenic trioxide (ATO) has been responsible for initially remarkable cure rates. However, relapsed APL, particularly in the high-risk subset of patients, remains an important clinical problem. In addition, despite the success of ATRA & ATO, many clinicians still elect to use cytotoxic chemotherapy in the treatment of APL. Patients who become resistant to ATO have an increased risk of mortality. The probability of relapse is significantly higher in the high-risk subset of patients undergoing treatment for APL; overall approximately 10-20% of APL patients relapse regardless of their risk stratification. Furthermore, 20-25% of patients undergoing treatment will develop differentiation syndrome, a common side effect of differentiation agents. Recent evidence using in vitro models has shown that mutations in the B2 domain of the PML protein, mediate arsenic resistance. Alternative agents and approaches considering these clinical outcomes are needed to address ATO resistance as well as the relapse rate in high risk APL.

show abstract

“…Among 269 APL with CR underwent maintenance random, four year relapse-free survival rate was 84% (ATRA) and 91% (Tamibarotene). In 52 high risk patients, this became significant (50% for ATRA, 87% for tamibarotene) 72 . In comparative analysis among those relapsed APL 74 , 80%(28/35) achieved CR and 22.86% CRm in tamibarotene-ATO versus 54.2% (19/35)CR with only 2.86-3.7% CRm in ATRA and ATO regimen 73 .…”

Section: Discussionmentioning

confidence: 99%

Treatment of Patients With Advanced Cancer Following Chemotherapy and Traditional Medicine - Long Term Follow Up of 75 Cases

Zhu

2018

UJPR

View full text Add to dashboard Cite

Objective: Traditional systems of medicine all over the world even traditional medicine and cancer have been using plants and plants products for therapeutic intention. The purpose of these retrospective trials is to assess the clinical efficacy of chemotherapy in conjunction with TCM for a broad variety of cancers. Methods: 75 patients with available cancers were concluded in the study during September1993 -May 2018.The sex ratio of male: female was 50:25 respectively. The mean age at onset was 46.9 years( range 10-79 years. All patients were treated with different dosage of various chemotherapy in combination with TCM or traditional medicine alone. The basic chemotherapeutic regimen consisted of vincristine( VCR, 1-2 mg/week)、 cyclophosphamide( CTX, 200-1, 000mg/ week), mitomycin C(MMC, 2-4mg/week) and 5-fluorouracil( 5-Fu,250-500mg/ day). The detail prescription of TCM varied among a broad variety of carcinomas. The criteria of complete remission( CR) and/or partial remission( PR) is according to the rules where physicians have in common with in clinics. In 75 cases, the CR was obtained in 33(44%) advanced cancers, a short CR in 11(14.7%) cases, PR in 25 (33.3%) cancers, stable disease in 6 cases.. The crude herbs consisted of sargassum, tangle, Oyster(mussels), Poria cocos, Ophiopogon japonicus, Prunella vulgaris, Taraxacum, Scrophularia ningpoensis, Cremastra appendiculata, Trichosanthes Kirilowii, Sophora subprostrata, Houttuynia cordata, Scutellaria barbata d. don and Oldenlandia diffusa roxb. Results: Among those long-term survivors, 31 carcinomas obtained in disease-free survival over 5 years, 20 cancers were survival over 10 years, the longest four patients over 25 years. Conclusion: In this study, it was experienced that a CR was a pivotal influencing factor in those longest survival patients, and traditional medicine was also recommended. Down regulating oncogenic receptors may be useful paradigm and perspective in currently the third line setting of clinical target therapy and in rendering our better understanding of cancer biology. Cite this article-George Zhu. Treatment of patients with advanced cancer following chemotherapy and traditional medicine -long term follow up of 75 cases. 16 CODEN (USA): UJPRA3 leukocytosis with development of retinoic acid syndrome, an important adverse reaction during treatment of APL. Thus, Tamibarotene demonstrated more efficacy in both untreated APL patients and relapsed who have been treated ATRA and chemotherapy, especially as novel strategy in relapsed APL in Japan and others 74-76 . This is encouraging perspective.

show abstract

Tamibarotene maintenance improved relapse-free survival of acute promyelocytic leukemia: a final result of prospective, randomized, JALSG-APL204 study

Cited by 30 publications

References 36 publications

Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet

Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet

Acute promyelocytic leukemia (APL): a review of the literature

Treatment of Patients With Advanced Cancer Following Chemotherapy and Traditional Medicine - Long Term Follow Up of 75 Cases

Contact Info

Product

Resources

About