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PART 2: Enter Vyxeos (CPX-351), a liposomal encapsulation of “7+3” in a 1:5 molar ratio. This ratio is “most” synergistic in vitro (PMID18676016). Liposomal form ensures high tissue distribution (esp. bone marrow). Fun Fact: It’s purple b/c dauno is red + copper gluconate blue! 
CPX-351 (n=153) was compared to 7+3 (dauno 60 mg/m2, n=156) in patients 60-75 with untreated sAML (note, did not include AML-MRC by morphology). PMID: 30024784
CPX-351 had a higher CR/CRi rate (47.7% vs. 33.3%, p=0.016), median EFS (2.53 vs. 1.31 mo., p=0.021), and median OS (9.56 vs. 5.95 mo., p=0.003). So, ~48% CR/Cri, EFS benefit of ~1 month, OS benefit of ~3.5 months. Is that a #gamechanger? What are some flaws with this study?
