Subcutaneous omacetaxine mepesuccinate in patients with chronic phase (CP) or accelerated phase (AP) chronic myeloid leukemia (CML) resistant/intolerant to two or three approved tyrosine-kinase inhibitors (TKIs).
Bibliographic record
Abstract
6513 Background: Omacetaxine mepesuccinate (“omacetaxine”) is a first-in-class, reversible, transient inhibitor of protein elongation that facilitates tumor cell death without depending on BCR-ABL signaling. Clinical activity was shown in two phase 2, open-label, multicenter studies in treatment-resistant CML. Methods: A subset from the phase 2 studies included patients in CP or AP who were resistant/intolerant to ≥2 approved TKIs. Omacetaxine 1.25 mg/m2 was given SC twice daily: ≤14 consecutive days/28-day cycle for induction, ≤7 days/cycle as maintenance. Secondary results were calculated for responses by number of prior TKIs. Results: Of 122 patients (median age, 60 years), 62 had received 2 TKIs (100% imatinib; 76% dasatinib; 24% nilotinib) and 60 had received all 3 approved TKIs. Prior non-TKI therapies (eg, 52% hydroxyurea, 34% interferon) were common. Of 45 CP patients in the 2 TKI group, 12 (27%) had major cytogenetic response (MCyR; median duration of 17.7 mo), and of 36 in the 3 TKI group, 4 (11%) had MCyR (median duration not reached). Of 17 AP patients in the 2 TKI group, 6 (35%) had major hematologic response (MaHR; median duration, 13.4 mo), and of 24 in the 3 TKI group, 5 (21%) had MaHR (median duration, 6.4 mo). Median months of survival in the 2 and 3 TKI groups were 30.1 and not reached for CP and 12.0 and 24.6 for AP. Treatment-related grade 3/4 adverse events (AEs) occurred in 52 (84%) patients in the 2 TKI group and 42 (70%) in the 3 TKI group (most common: thrombocytopenia [71%, 48%]). Fifteen (24%) and 16 (27%) had an AE leading to discontinuation, primarily disease progression. There were 20 deaths (primarily disease progression), 11 in the 2 TKI group and 9 in the 3 TKI group; 4 were considered related to treatment (sepsis in 2, pancytopenia, febrile neutropenia). Conclusions: In patients with heavily pretreated CML, response to omacetaxine therapy occurred whether they had received 2 or 3 prior TKIs. The drug was well tolerated. Tolerability was similar across the TKI groups in both CP and AP patients. Support: Teva Pharmaceutical Industries Ltd.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".