J Clin Oncol: Efficacy and toxicity of Pegaspargase and Calaspargase Pegol in the treatment of childhood ALL

L- asparaginase treatment of children with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma important part (LL); however many toxic side effects, including pancreatitis, thrombosis embolism and allergic reactions
.

Although there have been decades of application experience, the best use plan to achieve the maximum efficacy and minimum toxicity of L-asparaginase is still unclear

Childhood Lymphoma Thrombosis

The DFCI 11-001 trial evaluated the efficacy and toxicity of a new type of pegylated asparaginase formulation (Calaspargase Pegol) compared with the standard formulation of Pegaspargase
.

Newly diagnosed ALL or lymphocytic lymphoma patients aged 1-21 years were randomly divided into two groups and received intravenous pegaspartase or pegylated asparaginase (2500 IU/m2)
.

After receiving an induction dose, the patient received pegaspase (1 time/2 weeks, total 15 doses) or pegylated asparaginase (1 time/3 weeks, total 10 doses) from the 7th week

Changes in median SAA levels after a single dose

Changes in median SAA levels after a single dose

From 2012 to 2015, a total of 239 patients (including 230 ALL and 9 lymphocytic lymphomas) were recruited: 120 were assigned to the pegaspase group and 119 were assigned to pegylated asparagine Enzyme group
.

After 18 days of induction therapy, 95% or more of the patients in both groups had SAA levels of 0.

After 18 days of induction therapy, 95% or more of the patients in both groups had SAA levels of 0.

Survival prognosis

Survival prognosis

With a median follow-up of 5.
3 years, the 5-year event-free survival rates of the pegaspase group and pegylated asparaginase group were 84.
9% and 88.
1%, respectively (p=0.
65)
.

With a median follow-up of 5.
3 years, the 5-year event-free survival rates of the pegaspase group and pegylated asparaginase group were 84.
9% and 88.
1%, respectively

Compared with pegasparaginase used every 2 weeks, the lowest SAA, toxicity, and survival prognosis results of pegylated asparaginase used every 3 weeks were similar
.

The SAA of the two preparations reached a high nadir, indicating that the drug delivery strategy can be further optimized

Original source:

Original source:

Lynda M.

Efficacy and Toxicity of Pegaspargase and Calaspargase Pegol in Childhood Acute Lymphoblastic Leukemia: Results of DFCI 11-001 in this message