Is it time for 5-azacytidine combinations in high-risk myelodysplastic syndrome patients?

Abstract

Evaluation of: Sekeres MA, Tiu RV, Komrokji R et al. Phase 2 study of the lenalidomide and azacitidine combination in patients with higher-risk myelodysplastic syndromes. Blood 120(25), 4945–4951 (2012).

High-risk myelodysplastic syndrome (MDS) patients have poor prognosis, and their median age is approximately 70 years. Allogeneic stem cell transplantation and high-dose chemotherapy are restricted to a relatively small minority of MDS. A hypomethylating agent, 5-azacytidine, has revolutionized the treatment of high-risk MDS patients by prolonging their survival by approximately 2 years. However this remains insufficient, and patients relapsing or refractory to 5-azacytidine have still a very poor prognosis. It is, therefore, necessary to improve the complete response rate obtained with 5-azacytidine alone and the combination with other molecules are mandatory. In this article, we resume the results and perspectives of a Phase II trial evaluating lenalidomide and 5-azacytidine combination in patients with higher-risk MDS.

Keywords::

• 5-azacytidine
• association
• DNMT3a
• high-risk IPSS
• IDH1/2
• lenalidomide
• myelodysplastic syndromes
• TET2
• toxicity

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.