Mitoxantrone, etoposide, and cytarabine (MEC)

A study evaluated one course of MEC chemotherapy in 74 patients with AML and a poor prognosis. The population included 30 patients with relapsed AML, 28 patients with primary refractory AML, and 16 patients with secondary AML.[5]

A study evaluated one course of MEC chemotherapy in 74 patients with AML and a poor prognosis. The population included 30 patients with relapsed AML, 28 patients with primary refractory AML, and 16 patients with secondary AML.[5]

MEC demonstrated a CR induction rate of 55%.[5][Level of evidence C3]

A phase III randomized Eastern Cooperative Oncology Group (ECOG) trial (E-2995) assessed 129 patients with one of the following disease statuses: relapsed AML less than 6 months after first CR; relapsed AML after allogeneic or autologous bone marrow transplant; second or greater AML relapse; primary induction failure; secondary AML; or high-risk myelodysplastic syndromes. Patients were randomly assigned to receive MEC with or without valspodar, a multidrug resistance modulator.

A phase III randomized Eastern Cooperative Oncology Group (ECOG) trial (E-2995) assessed 129 patients with one of the following disease statuses: relapsed AML less than 6 months after first CR; relapsed AML after allogeneic or autologous bone marrow transplant; second or greater AML relapse; primary induction failure; secondary AML; or high-risk myelodysplastic syndromes. Patients were randomly assigned to receive MEC with or without valspodar, a multidrug resistance modulator.

The complete response rate was only 17% to 25% in both arms.[6][Level of evidence B3]