Around 1 in 5 people diagnosed with cancer in the UK take part in a clinical trial.
A trial looking at intensive chemotherapy for people mainly over 60 with acute myeloid leukaemia (AML 14)
This trial was looking at different combinations of chemotherapy for older people with acute myeloid leukaemia (AML) or a bone marrow condition called
Doctors usually treat AML with chemotherapy. The first phase of treatment is called ‘induction’. It aims to get your leukaemia into
In this trial, the researchers were looking for ways to improve the treatment of AML in older people.
The people taking part had 3 or 4 courses of chemotherapy, with 3 different combinations of drugs. The researchers wanted to see if any of the different doses, or combinations of drugs helped to stop AML coming back.
The aims of the trial were to find out if
- Having higher doses of 2 of the drugs was better than lower doses
- Having 4 cycles of treatment was better than 3
- Adding a new drug called PSC-833 helped
Summary of results
The researchers found that higher doses of drugs did not help to stop AML coming back. And neither did having a 4th course of treatment, or having PSC-833.
The trial recruited 1,273 people. 142 of these people had myelodysplastic syndrome (MDS) that doctors thought was at high risk of becoming AML. The rest had AML, and most people were over 60.
For the first 2 courses of chemotherapy, everybody taking part had DAT (daunorubicin, cytarabine and tioguanine). Some people had higher doses of daunorubicin and cytarabine. Half the people having a lower dose of daunorubicin also had a new drug called PSC-833.
After the first 2 courses, everybody who was in remission had a 3rd course of treatment called MidAC (mitoxantrone, and cytarabine). Then people were put into 2 different groups, but neither they nor their doctors could choose which group they were in. This is called randomisation. Half had a 4th course of chemotherapy called ICE (idarubicin, cytarabine and etoposide). The other half had no more treatment.
Overall, AML and MDS responded to treatment in 62 out of every 100 people (62%) in the trial. And just over half (54%) had their disease go into complete remission. Increasing the dose of daunorubicin or cytarabine, or adding in PSC-833 or a 4th course of chemotherapy didn’t make a difference to how often AML came back, or to the number of people alive after 5 years.
We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (
How to join a clinical trial
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Professor AK Burnett
Professor AH Goldstone