ASH 2024 | Evaluating the impact of MRD by error-corrected NGS on patients with AML treated with CPX-351
David Sallman, MD, Moffitt Cancer Center, Tampa, FL, discusses the impact of CPX-351 on the treatment of patients with acute myeloid leukemia (AML), particularly those who undergo stem cell transplant. Dr Sallman then comments on the impact of measurable residual disease (MRD) negativity by error-corrected next-generation sequencing (NGS) on the outcomes of these patients. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI generated)
Yeah, so CPX, you know, changed the standard of care for secondary AML patients, where clearly survival, particularly patients who went to transplant, is much better than with 7 plus 3. Actually, we’ll hear at this congress, you know, CPX is also better than FLAG-IDA, particularly for these secondary type mutations. But then the bigger, the big question is why? You know, I think a lot of hypotheses was, does this lead to deeper MRD negative remissions post-transplant or is it something else? Is it that it’s in general better tolerated? You know, really open questions...
Yeah, so CPX, you know, changed the standard of care for secondary AML patients, where clearly survival, particularly patients who went to transplant, is much better than with 7 plus 3. Actually, we’ll hear at this congress, you know, CPX is also better than FLAG-IDA, particularly for these secondary type mutations. But then the bigger, the big question is why? You know, I think a lot of hypotheses was, does this lead to deeper MRD negative remissions post-transplant or is it something else? Is it that it’s in general better tolerated? You know, really open questions. So I think going into the study, we said, hey, CPX should lead to a very high degree of MRD negativity rates, not by flow, which has been published, but by deeper sequencing, this error-corrected NGS panel. I think kind of to our surprise, it’s actually quite rare to clear all your mutations, at least down to that 0.1% level. So even excluding DTA, which was really not an impact. You know, we only had several patients that completely cleared. Now, for what it’s worth, those patients did do great. One of them was an NPM1 mutant patient and was cured with just CPX therapy by itself. So not a lot of patients having deep clearance and really supports that, hey, these patients need to go to transplant or they’re going to relapse. I think what we found that was really impressive was that patients that got CPX went to transplant. If their post-allo specimen was MRD negative by error-corrected NGS, their outcomes were really impressive. We actually only had one patient out of the total cohort. It wasn’t huge, but eight or nine patients, but only one relapse. So I think it’s a really cool biomarker that, hey, if day plus 30, you are error-corrected NGS negative, you did remarkably well.
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Disclosures
Abbvie: Consultancy; Agios: Consultancy; Axiom: Consultancy; Gilead: Consultancy; Celyad: Consultancy; Froghorn: Consultancy; Incyte: Consultancy; Intellisphere, LLC: Consultancy; Johnson & Johnson: Consultancy; Kite: Consultancy, Membership on an entity’s Board of Directors or advisory committees; Magenta Therapeutics: Consultancy, Membership on an entity’s Board of Directors or advisory committees; NextTech: Consultancy; Novartis: Consultancy, Membership on an entity’s Board of Directors or advisory committees; AvenCell: Membership on an entity’s Board of Directors or advisory committees; Astellas: Membership on an entity’s Board of Directors or advisory committees; BlueBird Bio: Membership on an entity’s Board of Directors or advisory committees; BMS: Membership on an entity’s Board of Directors or advisory committees; Dark Blue Therapeutics: Membership on an entity’s Board of Directors or advisory committees; Intellia: Membership on an entity’s Board of Directors or advisory committees; Jasper Therapeutics: Membership on an entity’s Board of Directors or advisory committees; NKARTA: Membership on an entity’s Board of Directors or advisory committees; Orbital Therapeutics: Membership on an entity’s Board of Directors or advisory committees; Rigel Pharmaceuticals: Membership on an entity’s Board of Directors or advisory committees; Shattuck Labs: Membership on an entity’s Board of Directors or advisory committees; Servier: Membership on an entity’s Board of Directors or advisory committees; Syndax: Membership on an entity’s Board of Directors or advisory committees; Syros: Membership on an entity’s Board of Directors or advisory committees; Apera: Research Funding; Jazz: Research Funding.
