Azacitidine in Lower‐Risk Myelodysplastic Syndromes: A Meta‐Analysis of Data from Prospective Studies

Conclusion.Azacitidine effects in these patients, most with non‐del(5q) LR‐MDS, were promising and generally similar to those reported for lenalidomide in similar patients. The choice of initial therapy is important because most patients eventually stop responding to front‐line therapy and alternatives are limited.Implications for Practice.Lower‐risk myelodysplastic syndromes (LR‐MDS) are primarily characterized by anemia. After erythropoiesis‐stimulating agent (ESA) failure, lenalidomide and hypomethylating agents are the only remaining treatment options for most patients. This meta‐analysis of 233 azacitidine‐treated red blood cell (RBC) transfusion‐dependent patients with LR‐MDS (92.3% non‐del[5q]) from 7 studies showed 38.9% became RBC transfusion‐independent. There is no clear guidance regarding the optimal choice of lenalidomide or hypomethylating agents for patients with non‐del(5q) LR‐MDS following ESA failure. Clinical presentation (e.g., number of cytopenias) and potential outcomes after hypomethylating agent failure are factors to consider when making initial treatment decisions for LR‐MDS patients.

Source: The Oncologist - February 15, 2018 Category: Cancer & Oncology Authors: Rami Komrokji, Arlene S. Swern, David Grinblatt, Roger M. Lyons, Magnus Tobiasson, Lewis R. Silverman, Hamid Sayar, Ravi Vij, Albert Fliss, Nora Tu, Mary M. Sugrue Tags: Leukemias, Academia-Pharma Intersect, Hematologic Malignancies ‐ Pharma Intersect: Hematologic Malignancies Source Type: research