Phase to phase: Navigating drug combinations with hypomethylating agents in higher-risk MDS trials for optimal outcomes.

Autor: Merz AMA; Department of Hematology, Cellular Therapy, Hemostaseology and Infectious Disease, University Hospital of Leipzig, Leipzig, Germany., Sébert M; Service Hématologie Séniors, Hôpital Saint-Louis (AP-HP), Paris Cité University and INSERM U944, Paris, France., Sonntag J; Department of Hematology, Cellular Therapy, Hemostaseology and Infectious Disease, University Hospital of Leipzig, Leipzig, Germany., Kubasch AS; Department of Hematology, Cellular Therapy, Hemostaseology and Infectious Disease, University Hospital of Leipzig, Leipzig, Germany., Platzbecker U; Department of Hematology, Cellular Therapy, Hemostaseology and Infectious Disease, University Hospital of Leipzig, Leipzig, Germany. Electronic address: uwe.platzbecker@medizin.uni-leipzig.de., Adès L; Service Hématologie Séniors, Hôpital Saint-Louis (AP-HP), Paris Cité University and INSERM U944, Paris, France. Electronic address: lionel.ades@aphp.fr.
Jazyk: angličtina
Zdroj: Cancer treatment reviews [Cancer Treat Rev] 2024 Feb; Vol. 123, pp. 102673. Date of Electronic Publication: 2023 Dec 19.
DOI: 10.1016/j.ctrv.2023.102673
Abstrakt: Recent developments in high-risk Myelodysplastic Neoplasms (HR MDS) treatment are confronted with challenges in study design due to evolving drug combinations with Hypomethylating Agents (HMAs). The shift from the International Prognostic Scoring System (IPSS) to its molecular revision (IPSS-M) has notably influenced research and clinical practice. Introducing concepts like the MDS/AML overlap complicate classifications and including chronic myelomonocytic leukemia (CMML) in MDS studies introduces another layer of complexity. The International Consortium for MDS emphasizes aligning HR MDS criteria with the 2022 ELN criteria for AML. Differences in advancements between AML and MDS treatments and hematological toxicity in HR MDS underline the importance of detailed trial designs. Effective therapeutic strategies require accurate reporting of adverse events, highlighting the need for clarity in criteria like the Common Terminology Criteria for Adverse Events (CTCAE). We provide an overview on negative clinical trials in HR MDS, analyze possible reasons and explore possibilities to optimize future clinical trials in this challenging patient population.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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