Low-Dose Decitabine versus Low-Dose Azacitidine in Lower-Risk MDS

Sasaki, Koji; Jabbour, Elias; Montalban‐Bravo, Guillermo; Darbaniyan, Faezeh; Do, Kim‐Anh; Class, Caleb A.; Kanagal-Shamana, Rashmi; Kadia, Tapan M.; Borthakur, Gautam; Pemmaraju, Naveen; Cortés, Jorge E.; Ravandi, Farhad; Alvarado, Yesid; Chien, Kelly S.; Komrojki, Rami; Sekeres, Mikkael A.; Steensma, David P.; DeZern, Amy E.; Roboz, Gail J.; Soltysiak, Kelly A.; Yang, Hui; Kantarjian, Hagop M.

doi:10.1056/evidoa2200034

Cited by 19 publications

(11 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Advances in lower-intensity therapy in combination with targeted therapies, such as Menin inhibitors in patients with KMT2A rearrangements and NPM1 mutations, may lead to improved outcomes [ 56 , 57 , 58 , 59 ]. Additionally, improvements in the treatment of MDS with lower-intensity therapy will prevent disease progression and improve patient outcomes [ 26 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ].…”

Section: Intensive Chemotherapy Versus Low-intensity Chemotherapymentioning

confidence: 99%

Optimizing Treatment Options for Newly Diagnosed Acute Myeloid Leukemia in Older Patients with Comorbidities

Oshikawa

Sasaki

2023

Cancers

Self Cite

View full text Add to dashboard Cite

Traditionally, the goal of AML therapy has been to induce remission through intensive chemotherapy, maintain long-term remission using consolidation therapy, and achieve higher rates of a cure by allogeneic transplantation in patients with a poor prognosis. However, for the elderly patients and those with comorbidities, the toxicity often surpasses the therapeutic benefits of intensive chemotherapy. Consequently, low-intensity therapies, such as the combination of a hypomethylating agent with venetoclax, have emerged as promising treatment options for elderly patients. Given the rise of low-intensity therapies as the leading treatment option for the elderly, it is increasingly important to consider patients’ age and comorbidities when selecting a treatment option. The recently proposed comorbidity-based risk stratification for AML allows prognosis stratification not only in patients undergoing intensive chemotherapy, but also in those receiving low-intensity chemotherapy. Optimizing treatment intensity based on such risk stratification is anticipated to balance treatment efficacy and safety, and will ultimately improve the life expectancy for patients with AML.

show abstract

Section: Intensive Chemotherapy Versus Low-intensity Chemotherapymentioning

confidence: 99%

Optimizing Treatment Options for Newly Diagnosed Acute Myeloid Leukemia in Older Patients with Comorbidities

Oshikawa

Sasaki

2023

Cancers

Self Cite

View full text Add to dashboard Cite

show abstract

“…Luspatercept's safety profile was notable for an increased incidence of fatigue, dizziness, and gastrointestinal adverse effects, but grade 3-4 adverse events were rare, and there was no increased rate of AML transformation. 32 Luspatercept was approved by the US Food and Drug Association in 2020 for use in patients with MDS-RS. Although this subgroup of patients achieved impressive responses, the relatively narrow clinical applicability of luspatercept serves to highlight the unmet need among LR-MDS patients without RSs.…”

Section: Novel Maturation Agentsmentioning

confidence: 99%

“…Eight or more weeks of transfusion independence was achieved in 38% of patients treated with luspatercept versus 13% of patients in the placebo arm. Luspatercept's safety profile was notable for an increased incidence of fatigue, dizziness, and gastrointestinal adverse effects, but grade 3–4 adverse events were rare, and there was no increased rate of AML transformation 32 . Luspatercept was approved by the US Food and Drug Association in 2020 for use in patients with MDS-RS.…”

Section: Growth Factorsmentioning

confidence: 99%

The Management of Low-Risk Myelodysplastic Syndromes—Current Standards and Recent Advances

Randall

DeZern

2023

Cancer J

View full text Add to dashboard Cite

The myelodysplastic syndromes (MDSs) are a heterogeneous group of hematologic neoplasms with varied natural histories and prognoses. Specific to this review, treatment of low-risk MDS most often focuses on improving quality of life by correcting cytopenias, as opposed to urgent disease modification to avoid acute myeloid leukemia. These treatments include transfusion support with iron chelation when necessary, growth factors including novel maturation agents such as luspatercept, lenalidomide for del(5q) disease, and, increasingly, low-dose hypomethylating agents. Recent advances in the understanding of the genetic lesions that drive MDS have prompted a reassessment of how low-risk disease is defined and helped to identify a subset of low-risk MDS patients who may benefit from a more aggressive treatment paradigm, including hematopoietic stem cell transplantation.

show abstract

“…Allogeneic stem cell transplantation is a curative approach in relapsed or refractory hematologic malignancies. Recently, novel therapeutic regimens were developed with the combination of intensive chemotherapy with a target agent and lower-intensity therapy to prevent progression or relapse [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 ]. The assessment of next generation sequencing [ 9 , 10 , 11 , 12 , 13 , 14 ], transcriptomic analysis [ 15 , 16 , 17 , 18 ], ultra-accurate duplex sequencing [ 19 ], optical genome mapping [ 20 ], and measurable residual diseases [ 21 , 22 , 23 ] enhanced the accuracy of prediction for prognosis [ 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Advances in Immunotherapies for Hematological Malignancies

Nogami

Sasaki

2022

IJMS

Self Cite

View full text Add to dashboard Cite

Following the success of immunotherapies such as chimeric antigen receptor transgenic T-cell (CAR-T) therapy, bispecific T-cell engager therapy, and immune checkpoint inhibitors in the treatment of hematologic malignancies, further studies are underway to improve the efficacy of these immunotherapies and to reduce the complications associated with their use in combination with other immune checkpoint inhibitors and conventional chemotherapy. Studies of novel therapeutic strategies such as bispecific (tandem or dual) CAR-T, bispecific killer cell engager, trispecific killer cell engager, and dual affinity retargeting therapies are also underway. Because of these studies and the discovery of novel immunotherapeutic target molecules, the use of immunotherapy for diseases initially thought to be less promising to treat with this treatment method, such as acute myeloid leukemia and T-cell hematologic tumors, has become a reality. Thus, in this coming era of new transplantation- and chemotherapy-free treatment strategies, it is imperative for both scientists and clinicians to understand the molecular immunity of hematologic malignancies. In this review, we focus on the remarkable development of immunotherapies that could change the prognosis of hematologic diseases. We also review the molecular mechanisms, development processes, clinical efficacies, and problems of new agents.

show abstract

Low-Dose Decitabine versus Low-Dose Azacitidine in Lower-Risk MDS

Cited by 19 publications

References 23 publications

Optimizing Treatment Options for Newly Diagnosed Acute Myeloid Leukemia in Older Patients with Comorbidities

Optimizing Treatment Options for Newly Diagnosed Acute Myeloid Leukemia in Older Patients with Comorbidities

The Management of Low-Risk Myelodysplastic Syndromes—Current Standards and Recent Advances

Therapeutic Advances in Immunotherapies for Hematological Malignancies

Contact Info

Product

Resources

About