Sorafenib or placebo in patients with newly diagnosed acute myeloid leukaemia: long-term follow-up of the randomized controlled SORAML trial

• Published in: Leukemia Vol. 35; no. 9; pp. 2517 - 2525
• Main Authors: Röllig, Christoph, Serve, Hubert, Noppeney, Richard, Hanoun, Maher, Krug, Utz, Baldus, Claudia D, Brandts, Christian H, Kunzmann, Volker, Einsele, Hermann, Krämer, Alwin, Müller-Tidow, Carsten, Schäfer-Eckart, Kerstin, Neubauer, Andreas, Burchert, Andreas, Giagounidis, Aristoteles, Krause, Stefan W, Mackensen, Andreas, Aulitzky, Walter, Herbst, Regina, Hänel, Mathias, Frickhofen, Norbert, Kullmer, Johannes, Kaiser, Ulrich, Kiani, Alexander, Link, Hartmut, Geer, Thomas, Reichle, Albrecht, Junghanß, Christian, Repp, Roland, Meinhardt, Achim, Dürk, Heinz, Klut, Ina-Maria, Bornhäuser, Martin, Schaich, Markus, Parmentier, Stefani, Görner, Martin, Thiede, Christian, von Bonin, Malte, Platzbecker, Uwe, Schetelig, Johannes, Kramer, Michael, Berdel, Wolfgang E, Ehninger, Gerhard
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.09.2021; Nature Publishing Group UK
• Subjects: Acute myeloid leukemia; Chemotherapy; Evaluation; Inhibitor drugs; Leukemia; Patients; Placebos; Prognosis; Prolongation; Randomization; Stem cell transplantation; Stem cells; Survival; Transplantation; Germany
• ISSN: 0887-6924; 1476-5551
• DOI: 10.1038/s41375-021-01148-x

Early results of the randomized placebo-controlled SORAML trial showed that, in patients with newly diagnosed acute myeloid leukaemia (AML), sorafenib led to a significant improvement in event-free (EFS) and relapse-free survival (RFS). In order to describe second-line treatments and their implications on overall survival (OS), we performed a study after a median follow-up time of 78 months. Newly diagnosed fit AML patients aged ≤60 years received sorafenib (n = 134) or placebo (n = 133) in addition to standard chemotherapy and as maintenance treatment. The 5-year EFS was 41 versus 27% (HR 0.68; p = 0.011) and 5-year RFS was 53 versus 36% (HR 0.64; p = 0.035). Allogeneic stem cell transplantation (allo SCT) was performed in 88% of the relapsed patients. Four years after salvage allo SCT, the cumulative incidence of relapse was 54 versus 35%, and OS was 32 versus 50%. The 5-year OS from randomization in all study patients was 61 versus 53% (HR 0.82; p = 0.282). In conclusion, the addition of sorafenib to chemotherapy led to a significant prolongation of EFS and RFS. Although the OS benefit did not reach statistical significance, these results confirm the antileukaemic activity of sorafenib.