Recent clinical data have shown a synergistic effect of venetoclax in combination with the hypomethylating agents (HMA) azacitidine and decitabine (complete remission [CR]/CR with incomplete cell count recovery [CRi]: 73%, median overall survival [OS] of 17.5 months) as well as low-dose cytarabine (LDAC; CR/CRi: 54%; median OS of 10.1 months) in the frontline setting in older patients with acute myeloid leukemia (AML) and those ineligible for intensive chemotherapy leading to approval of both combinations in the US. 1,2 However, data on relapsed/refractory (R/R)-AML are scarce and heterogenous. Outcomes of patients with R/R-AML are dismal with a median OS of 3-7 months and there is no approved standard of care. 3 Multiple clinical trials combining either venetoclax alone, venetoclax + HMA or venetoclax + LDAC as the backbone of therapy with other novel agents in R/R-AML are ongoing. As many of these trials are not randomized, it is vital to understand the response rate to venetoclax alone and venetoclax + HMA/LDAC in R/R-AML to use it as a benchmark for comparison.Therefore, we performed a systematic literature review and meta-analysis to objectively assess overall response rates (ORR), and rates of CR/CRi for R/R-AML patients treated with venetoclax or venetoclax + HMA/LDAC. MEDLINE via PubMed, Ovid EMBASE, the COCHRANE registry of clinical trials (CENTRAL), Scopus and the Web of Science electronic databases were
Data on the efficacy and safety of interferon (IFN)-α for the treatment of essential thrombocythemia (ET) and polycythemia vera (PV) are inconsistent. We conducted a systematic review and meta-analysis and searched MEDLINE and EMBASE via Ovid, Scopus, COCHRANE registry of clinical trials (CENTRAL), and Web of Science from inception through 03/2019 for studies of pegylated IFN (peg-IFN) and non-pegylated IFN (non-peg-IFN) in PV and ET patients. Random-effects models were used to pool response rates for the primary outcome of overall response rate (ORR) defined as a composite of complete response, partial response, complete hematologic response (CHR) and partial hematologic response. Peg-IFN and non-peg-IFN were compared by meta-regression analyses.
44 studies with 1359 patients (730 ET, 629 PV) were included. ORR were 80.6% (95% confidence interval: 76.6–84.1%, CHR: 59.0% [51.5%−66.1%]) and 76.7% (67.4–84.0%; CHR: 48.5% [37.8–59.4%]) for ET and PV patients, respectively. In meta-regression analyses results did not differ significantly for non-peg-IFN vs. peg-IFN. Annualized rates of thromboembolic complications and treatment discontinuation due to adverse events were low at 1.2% and 8.8% for ET and 0.5% and 6.5% for PV patients, respectively. Both peg-IFN and non-peg-IFN can be effective and safe long-term treatments for ET and PV.
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