# CPX-351 versus 7+3 chemotherapy in older adults with newly diagnosed secondary acute myeloid leukaemia

Source: https://onco.cc/key-papers/paper-cpx-351-study-301-lancet-je-jco-2018/  
OnCo record `paper-cpx-351-study-301-lancet-je-jco-2018` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A liposomal formulation locking cytarabine and daunorubicin in a fixed ratio lengthened survival compared with standard 7+3 chemotherapy in patients aged 60 to 75 with secondary or therapy-related acute myeloid leukaemia, and more of them reached transplant.

## Summary

Phase 3 trial of 309 patients aged 60 to 75 with newly diagnosed high-risk or secondary AML randomised to CPX-351 or conventional cytarabine plus daunorubicin (7+3).

Median overall survival was 9.56 months with CPX-351 against 5.95 months with 7+3 (hazard ratio 0.69); remission rates were higher and outcomes after transplant were better, with a longer recovery of blood counts as the main cost.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: Journal of Clinical Oncology
- Year: 2018
- DOI: 10.1200/JCO.2017.77.6112
- Authors: Lancet JE, Uy GL, Cortes JE, et al.
- Findings: Median overall survival 9.56 vs 5.95 months; hazard ratio 0.69.; Complete remission (with or without incomplete recovery) 47.7 percent vs 33.3 percent.
- What it means: CPX-351 is the preferred intensive induction for fit older patients with secondary or therapy-related AML in many centres, mainly as a bridge to allogeneic transplant.
- Caveats: Open-label; longer neutropenia and thrombocytopenia with CPX-351.; Benefit in patients under 60 and in de novo AML is not established.

## Sources

- J Clin Oncol 2018: https://doi.org/10.1200/JCO.2017.77.6112
- PubMed: https://pubmed.ncbi.nlm.nih.gov/30024784/

## Connected records

- cancers: [Secondary and therapy-related acute myeloid leukaemia](https://onco.cc/cancers/aml-secondary/)
- drugs: [Cytarabine](https://onco.cc/drugs/cytarabine/), [Daunorubicin](https://onco.cc/drugs/daunorubicin/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)

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