Difference between revisions of "Chronic myelomonocytic leukemia"
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Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are [[How_to_contribute|invited to contribute to the site]]. | Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are [[How_to_contribute|invited to contribute to the site]]. | ||
Revision as of 13:08, 25 January 2018
Carboplatin & Paclitaxel (CP)
CP: Carboplatin & Paclitaxel
Regimen
| Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
|---|---|---|---|---|
| Forde et al. 2022 (CheckMate 816) | 2017-2019 | Phase 3 (C) | 1a. CP & Nivolumab 1b. CVb & Nivolumab 1c. DC & Nivolumab |
Inferior EFS |
Note: there were additional comparator options depending on histology; see the respective histology-specific pages for more details. This study was conducted in the United States. The reason for the study was that an unanswered question at the time was whether adding an immune checkpoint inhibitor would improve outcomes.
Biomarker eligibility criteria
- CheckMate 816: No sensitizing EGFR or ALK mutations
Chemotherapy
- Carboplatin (Paraplatin) AUC 5 or 6 IV once on day 1
- Paclitaxel (Taxol) 175 or 200 mg/m2 IV once on day 1
21-day cycle for 3 cycles
Subsequent treatment
References
- CheckMate 816: Forde PM, Spicer J, Lu S, Provencio M, Mitsudomi T, Awad MM, Felip E, Broderick SR, Brahmer JR, Swanson SJ, Kerr K, Wang C, Ciuleanu TE, Saylors GB, Tanaka F, Ito H, Chen KN, Liberman M, Vokes EE, Taube JM, Dorange C, Cai J, Fiore J, Jarkowski A, Balli D, Sausen M, Pandya D, Calvet CY, Girard N; CheckMate 816 Investigators. Neoadjuvant Nivolumab plus Chemotherapy in Resectable Lung Cancer. N Engl J Med. 2022 May 26;386(21):1973-1985. Epub 2022 Apr 11. link to original article contains dosing details in manuscript PubMed NCT02998528
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Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer. If this is your first time visiting, we suggest you read the tutorial.
Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are invited to contribute to the site.
| Section editor | |
|---|---|
 |
Sanjay R. Mohan, MD, MSCI Nashville, TN |
7 regimens on this page
10 variants on this page
|
Guidelines
International expert panel
- Allogeneic hematopoietic stem cell transplantation for MDS and CMML: recommendations from an international expert panel. (2017) PubMed
NCCN
First-line therapy
Azacitidine monotherapy
| back to top |
Regimen #1, 7 days
| Study | Evidence | Comparator | Efficacy |
|---|---|---|---|
| Sekeres et al. 2017 (SWOG S1117) | Randomized Phase II, <20 pts in subgroup | Azacitidine & Lenalidomide | Seems not superior |
| Azacitidine & Vorinostat | Seems not superior |
Chemotherapy
- Azacitidine (Vidaza) 75 mg/m2 SC/IV once per day on days 1 to 7
28-day cycles
Regimen #2, 5-2-2
| Study | Evidence | Comparator | Efficacy |
|---|---|---|---|
| Drummond et al. 2014 | Phase II | ||
| Sekeres et al. 2017 (SWOG S1117) | Randomized Phase II, <20 pts in subgroup | Azacitidine & Lenalidomide | Seems not superior |
| Azacitidine & Vorinostat | Seems not superior |
Chemotherapy
- Azacitidine (Vidaza) 75 mg/m2 IV once per day on days 1 to 5, 8 & 9
28-day cycle for at least 6 cycles, then continued for responders or SD until progression or intolerance.
References
- Drummond MW, Pocock C, Boissinot M, Mills J, Brown J, Cauchy P, Cross NC, Hartley S, Kell J, Szubert A, Cockerill PN, Bowen DT. A multi-centre phase 2 study of azacitidine in chronic myelomonocytic leukaemia. Leukemia. 2014 Jul;28(7):1570-2. Epub 2014 Feb 26. link to original article contains verified protocol PubMed
- Sekeres MA, Othus M, List AF, Odenike O, Stone RM, Gore SD, Litzow MR, Buckstein R, Fang M, Roulston D, Bloomfield CD, Moseley A, Nazha A, Zhang Y, Velasco MR, Gaur R, Atallah E, Attar EC, Cook EK, Cull AH, Rauh MJ, Appelbaum FR, Erba HP. Randomized phase II study of azacitidine alone or in combination with lenalidomide or with vorinostat in higher-risk myelodysplastic syndromes and chronic myelomonocytic leukemia: North American Intergroup Study SWOG S1117. J Clin Oncol. 2017 Aug 20;35(24):2745-2753. Epub 2017 May 9. link to original article contains verified protocol PubMed
Azacitidine & Lenalidomide
| back to top |
Regimen #1, 7 days of azacitidine
| Study | Evidence | Comparator | Efficacy |
|---|---|---|---|
| Sekeres et al. 2017 (SWOG S1117) | Randomized Phase II, <20 pts in subgroup | Azacitidine | Seems not superior |
| Azacitidine & Vorinostat | Not reported |
Chemotherapy
- Azacitidine (Vidaza) 75 mg/m2 SC/IV once per day on days 1 to 7
- Lenalidomide (Revlimid) 10 mg PO once per day on days 1 to 21
28-day cycles
Regimen #2, 5-2-2 azacitidine
| Study | Evidence | Comparator | Efficacy |
|---|---|---|---|
| Sekeres et al. 2017 (SWOG S1117) | Randomized Phase II, <20 pts in subgroup | Azacitidine | Seems not superior |
| Azacitidine & Vorinostat | Not reported |
Chemotherapy
- Azacitidine (Vidaza) 75 mg/m2 SC/IV once per day on days 1 to 5, 8 & 9
- Lenalidomide (Revlimid) 10 mg PO once per day on days 1 to 21
28-day cycles
References
- Sekeres MA, Othus M, List AF, Odenike O, Stone RM, Gore SD, Litzow MR, Buckstein R, Fang M, Roulston D, Bloomfield CD, Moseley A, Nazha A, Zhang Y, Velasco MR, Gaur R, Atallah E, Attar EC, Cook EK, Cull AH, Rauh MJ, Appelbaum FR, Erba HP. Randomized phase II study of azacitidine alone or in combination with lenalidomide or with vorinostat in higher-risk myelodysplastic syndromes and chronic myelomonocytic leukemia: North American Intergroup Study SWOG S1117. J Clin Oncol. 2017 Aug 20;35(24):2745-2753. Epub 2017 May 9. link to original article contains verified protocol PubMed
Azacitidine & Vorinostat
| back to top |
Regimen #1, 7 days of azacitidine
| Study | Evidence | Comparator | Efficacy |
|---|---|---|---|
| Sekeres et al. 2017 (SWOG S1117) | Randomized Phase II, <20 pts in subgroup | Azacitidine | Seems not superior |
| Azacitidine & Lenalidomide | Not reported |
Chemotherapy
- Azacitidine (Vidaza) 75 mg/m2 SC/IV once per day on days 1 to 7
- Vorinostat (Zolinza) 300 mg PO BID on days 3 to 9
28-day cycles
Regimen #2, 5-2-2 azacitidine
| Study | Evidence | Comparator | Efficacy |
|---|---|---|---|
| Sekeres et al. 2017 (SWOG S1117) | Randomized Phase II, <20 pts in subgroup | Azacitidine | Seems not superior |
| Azacitidine & Lenalidomide | Not reported |
Chemotherapy
- Azacitidine (Vidaza) 75 mg/m2 SC/IV once per day on days 1 to 5, 8 & 9
- Vorinostat (Zolinza) 300 mg PO BID on days 3 to 9
28-day cycles
References
- Sekeres MA, Othus M, List AF, Odenike O, Stone RM, Gore SD, Litzow MR, Buckstein R, Fang M, Roulston D, Bloomfield CD, Moseley A, Nazha A, Zhang Y, Velasco MR, Gaur R, Atallah E, Attar EC, Cook EK, Cull AH, Rauh MJ, Appelbaum FR, Erba HP. Randomized phase II study of azacitidine alone or in combination with lenalidomide or with vorinostat in higher-risk myelodysplastic syndromes and chronic myelomonocytic leukemia: North American Intergroup Study SWOG S1117. J Clin Oncol. 2017 Aug 20;35(24):2745-2753. Epub 2017 May 9. link to original article contains verified protocol PubMed
Maintenance after first-line therapy
Azacitidine monotherapy
| back to top |
Regimen
| Study | Evidence |
|---|---|
| Grövdal et al. 2010 | Phase II |
Chemotherapy
- Azacitidine (Vidaza) 60 mg/m2 SC once per day on days 1 to 5
28-day cycles
References
- Grövdal M, Karimi M, Khan R, Aggerholm A, Antunovic P, Astermark J, Bernell P, Engström LM, Kjeldsen L, Linder O, Nilsson L, Olsson A, Holm MS, Tangen JM, Wallvik J, Oberg G, Hokland P, Jacobsen SE, Porwit A, Hellström-Lindberg E. Maintenance treatment with azacytidine for patients with high-risk myelodysplastic syndromes (MDS) or acute myeloid leukaemia following MDS in complete remission after induction chemotherapy. Br J Haematol. 2010 Aug;150(3):293-302. Epub 2010 May 20. link to original article contains verified protocol PubMed content property of HemOnc.org