title: Vosaroxin is a novel topoisomerase-II inhibitor with efficacy in relapsed and refractory acute myeloid leukaemia.
abstract: BACKGROUND
  Vosaroxin is a first-in-class anti-cancer quinolone that inhibits topoisomerase-II leading to cell cycle arrest and apoptosis. It has shown efficacy in a range of solid organ and haematopoietic tumours in vitro, and several clinical trials are underway or completed in the field of Acute Myeloid Leukaemia (AML). The treatment of relapsed and refractory AML is a clinical challenge, where long-term survival is rare without allogeneic haematopoietic stem cell transplantation.
  
  
  METHODS
  We review the data from the published clinical trials of vosaroxin, including the recently presented Phase III VALOR study. In combination with intermediate dose cytarabine, vosaroxin almost doubled complete response (CR) rates in relapsed and refractory AML compared with cytarabine alone, and prolonged median survival by 1.4 months.
  
  
  CONCLUSIONS
  Vosaroxin is a promising new agent in the treatment of AML, with the potential to improve CR rates in a high-risk group of patients with relapsed and refractory AML. However, higher CR rates have been associated with higher rates of treatment-related morbidity and mortality, especially in elderly/unfit patients. Maximising the potential of vosaroxin will therefore require the identification of patients most likely to benefit from vosaroxin-containing combination regimens.
authors.affiliation: Royal Adelaide Hospital, Leukaemia Fellow, SA Pathology , Adelaide, SA 5000 , Australia.
authors.forename: Anya K
authors.initials: AK
authors.lastname: Hotinski
authors.forename: Ian D
authors.initials: ID
authors.lastname: Lewis
authors.forename: David M
authors.initials: DM
authors.lastname: Ross
mesh_terms: D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003561:Cytarabine / Q000008:administration & dosage; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D009287:Naphthyridines / Q000494:pharmacology / Q000627:therapeutic use*; D012008:Recurrence; D013844:Thiazoles / Q000494:pharmacology / Q000627:therapeutic use*; D059003:Topoisomerase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D017211:Treatment Failure
chemical_list: D000970:Antineoplastic Agents; D009287:Naphthyridines; D013844:Thiazoles; D059003:Topoisomerase Inhibitors; D003561:Cytarabine; C485113:vosaroxin
keywords: SNS-595; acute myeloid leukaemia; elderly; refractory; relapsed; topoisomerase-II; voreloxin; vosaroxin