Last year in the UK over 60,000 cancer patients enrolled on clinical trials aimed at improving cancer treatments and making them available to all.
A trial looking at treatment for acute promyelocytic leukaemia (AML17)
This trial was for adults with acute promyelocytic leukaemia (APL).
Cancer Research UK supported this trial.
More about this trial
ATRA and a chemotherapy drug called idarubicin is the usual first treatment for APL. ATRA is similar to vitamin A and is also called tretinoin or Vesinoid. This was the
In this trial, they looked at a treatment called arsenic trioxide. It is also called trisenox or ATO. Arsenic trioxide works by speeding up the death of leukaemic cells and encouraging normal blood cells to develop properly. It does this by working on particular proteins within the cell.
The researchers thought ATRA and arsenic trioxide might work as well as standard treatment and have fewer side effects. But they weren’t sure so wanted to find out more. This trial compared the following treatments:
- ATRA and chemotherapy
- ATRA and arsenic trioxide
The main aims of the trial were find out:
- how treatment affected quality of life
- which treatment worked best
- long people lived for after treatment
- more about the side effects
Please note - there is another part of the AML17 trial that looked at different treatment for acute myeloid leukaemia (AML). We have a summary for the results for this part of the AML17 trial on our trials database.
Summary of results
The trial team found that ATRA and arsenic trioxide worked well for people with a high or low risk of their acute promyelocytic leukaemia (APL) coming back. The leukaemia came back in fewer people who had this treatment. But overall there was no difference in how long people lived for after either of the 2 treatments, or in quality of life.
235 people with APL people took part. Of those, 57 had a high risk of their leukaemia coming back. Everyone was put into 1 of 2 groups at
- 119 had ATRA and idarubicin
- 116 had ATRA and arsenic trioxide
The trial team looked at how well treatment worked. They found the leukaemia went away completely (complete remission) in just
- under 9 out of 10 people (89%) who had ATRA and chemotherapy
- over 9 out of 10 people (94%) who had ATRA and arsenic trioxide
They also looked at whose cancer had come back (relapsed). This happened in:
- 19 people who had ATRA and idarubicin
- 1 person who had ATRA and arsenic trioxide
They didn’t find a significant difference in:
- the number of people living 4 years after treatment
- quality of life
As expected, people who had ATRA and chemotherapy had more serious side effects. These included hair loss and mouth problems.
People who had ATRA and arsenic trioxide had higher levels of liver enzymes after the 1st course of treatment. But these levels went back to normal and there were no further problems during the 2nd course.
People who had ATRA and idarubicin spent more days in hospital and needed more supportive care such as antibiotics.
The research team concluded that ATRA and arsenic trioxide did not improve quality of life compared with standard treatment. But they say this study confirms that it is an acceptable treatment for people with both low and high risk APL.
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (
How to join a clinical trial
Professor A K Burnett
Professor N H Russell
Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
NIHR Clinical Research Network: Cancer
This is Cancer Research UK trial number CRUK/08/025.