Could Androgen Therapy Increase Survival Rate in Acute Myeloid Leukemia?

A new study found that the incorporation of androgens into maintenance therapy for acute myeloid leukemia improved survival rates in elderly patients.

Researchers used a randomized open-label trial to explore the benefits of incorporating androgen therapy into the maintenance therapy for acute myeloid leukemia in elderly patients. The study included 330 patients diagnosed with de nova or secondary acute myeloid leukemia, and undergoing chemotherapy or radiotherapy.
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Participants in the study took idarubicin 8 mg/m² on days 1 to 5, cytarabine 100 mg/m² on days 1 to 7, and lomustine 200 mg/m² on day 1 as a part of their induction therapy. Participants in partial or complete remission received 6 reinduction courses of alternating idarubicin 8 mg/m² on day 1, cytarabine 100 mg/m² on day 1 to 5, and methotrexate and mercaptopurine. In addition, patients were randomly assigned according to their body weight 10 or 20 mg/day of Noretheandrolone, or no norethandrolone as part of the 2-year maintenance therapy.

Overall, 247 patients (76%) achieved complete or partial remission. Participants who received norethandrolone had an overall survival rate of 26.3%, an event-free survival rate of 21.5%, and a 5-year disease-free survival rate of 31.2%. Those who did not receive norethandrolone had an overall survival rate of 17.2%, an event-free survival rate of 12.9%, and a 5-year disease-free survival rate of 17.2%. Patients with baseline leukocytes > 30 × 10⁹/L were the only participants who saw no benefit from taking norethandrolone as a part of their maintenance treatment.

In conclusion, the researchers demonstrated that norethandrolone included with maintenance therapy for treating acute myeloid leukemia significantly improved elderly patients’ survival. 

—Melissa Weiss

Reference:

Pigneux A, Béné MC, Guardiola P, et al. Addition of androgens improves survival in elderly patients with acute myeloid leukemia: a GOELAMS study [published online October 24, 2016]. Journal of Clinical Oncology. doi:10.1200/JCO.2016.67.6213