Combining treatment options for myelodysplastic syndromes and chronic myelomonocytic leukaemia

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07/04/23

Dr Sekeres talks to ecancertv at ASH 2015 about a North American study (SWOG S1117) that tried to expand the treatment options for patients with higher risk myelodysplastic syndromes (MDS) and chronic myelomonocytic leukaemia (CMML).

There are few treatments available to treat patients with higher risk MDS and CMML and these have a limited impact on outcome, with around a 35% overall response rate (ORR) to azacitidine when it is used alone.

The SWOG S1117 looked at adding the immunomodulatory lenalidomide or the histone deacetylase inhibitor vorinostat to azacitidine to see if ORR could be improved versus azacitidine monotherapy.

The ORR and overall survival was similar for azacitidine monotherapy compared to the combination arms in patients with higher risk MDS. However, the ORR was significantly higher than the monotherapy when lenalidomide was added to azacitidine in patients with CMML.

Dr Sekeres comments that dose reductions in the combination arms might have played a role in the somewhat disappointing findings. Data will need to be pooled to see if there are patient subgroups who might particularly benefit from the combination therapies.