Difference between revisions of "Chronic myelomonocytic leukemia"
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|[[Levels_of_Evidence#Efficacy|'''Efficacy''']] | |[[Levels_of_Evidence#Efficacy|'''Efficacy''']] | ||
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− | |rowspan=2|[http://ascopubs.org/doi/ | + | |rowspan=2|[http://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 Sekeres et al. 2017 (SWOG S1117)] |
|rowspan=2 style="background-color:#eeee00"|Randomized Phase II, <20 pts in subgroup | |rowspan=2 style="background-color:#eeee00"|Randomized Phase II, <20 pts in subgroup | ||
|[[#Azacitidine_.26_Lenalidomide|Azacitidine & Lenalidomide]] | |[[#Azacitidine_.26_Lenalidomide|Azacitidine & Lenalidomide]] | ||
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|style="background-color:#d3d3d3"| | |style="background-color:#d3d3d3"| | ||
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− | |rowspan=2|[http://ascopubs.org/doi/ | + | |rowspan=2|[http://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 Sekeres et al. 2017 (SWOG S1117)] |
|rowspan=2 style="background-color:#eeee00"|Randomized Phase II, <20 pts in subgroup | |rowspan=2 style="background-color:#eeee00"|Randomized Phase II, <20 pts in subgroup | ||
|[[#Azacitidine_.26_Lenalidomide|Azacitidine & Lenalidomide]] | |[[#Azacitidine_.26_Lenalidomide|Azacitidine & Lenalidomide]] | ||
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===References=== | ===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. [http://www.nature.com/leu/journal/v28/n7/full/leu201485a.html link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/24569776 PubMed] | # 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. [http://www.nature.com/leu/journal/v28/n7/full/leu201485a.html link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/24569776 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. [http://ascopubs.org/doi/ | + | # 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. [http://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/28486043 PubMed] |
==Azacitidine & Lenalidomide {{#subobject:92571f|Regimen=1}}== | ==Azacitidine & Lenalidomide {{#subobject:92571f|Regimen=1}}== | ||
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|[[Levels_of_Evidence#Efficacy|'''Efficacy''']] | |[[Levels_of_Evidence#Efficacy|'''Efficacy''']] | ||
|- | |- | ||
− | |rowspan=2|[http://ascopubs.org/doi/ | + | |rowspan=2|[http://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 Sekeres et al. 2017 (SWOG S1117)] |
|rowspan=2 style="background-color:#eeee00"|Randomized Phase II, <20 pts in subgroup | |rowspan=2 style="background-color:#eeee00"|Randomized Phase II, <20 pts in subgroup | ||
|[[#Azacitidine_monotherapy|Azacitidine]] | |[[#Azacitidine_monotherapy|Azacitidine]] | ||
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|[[Levels_of_Evidence#Efficacy|'''Efficacy''']] | |[[Levels_of_Evidence#Efficacy|'''Efficacy''']] | ||
|- | |- | ||
− | |rowspan=2|[http://ascopubs.org/doi/ | + | |rowspan=2|[http://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 Sekeres et al. 2017 (SWOG S1117)] |
|rowspan=2 style="background-color:#eeee00"|Randomized Phase II, <20 pts in subgroup | |rowspan=2 style="background-color:#eeee00"|Randomized Phase II, <20 pts in subgroup | ||
|[[#Azacitidine_monotherapy|Azacitidine]] | |[[#Azacitidine_monotherapy|Azacitidine]] | ||
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===References=== | ===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. [http://ascopubs.org/doi/ | + | # 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. [http://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/28486043 PubMed] |
==Azacitidine & Vorinostat {{#subobject:a816bd|Regimen=1}}== | ==Azacitidine & Vorinostat {{#subobject:a816bd|Regimen=1}}== | ||
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|[[Levels_of_Evidence#Efficacy|'''Efficacy''']] | |[[Levels_of_Evidence#Efficacy|'''Efficacy''']] | ||
|- | |- | ||
− | |rowspan=2|[http://ascopubs.org/doi/ | + | |rowspan=2|[http://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 Sekeres et al. 2017 (SWOG S1117)] |
|rowspan=2 style="background-color:#eeee00"|Randomized Phase II, <20 pts in subgroup | |rowspan=2 style="background-color:#eeee00"|Randomized Phase II, <20 pts in subgroup | ||
|[[#Azacitidine_monotherapy|Azacitidine]] | |[[#Azacitidine_monotherapy|Azacitidine]] | ||
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|[[Levels_of_Evidence#Efficacy|'''Efficacy''']] | |[[Levels_of_Evidence#Efficacy|'''Efficacy''']] | ||
|- | |- | ||
− | |rowspan=2|[http://ascopubs.org/doi/ | + | |rowspan=2|[http://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 Sekeres et al. 2017 (SWOG S1117)] |
|rowspan=2 style="background-color:#eeee00"|Randomized Phase II, <20 pts in subgroup | |rowspan=2 style="background-color:#eeee00"|Randomized Phase II, <20 pts in subgroup | ||
|[[#Azacitidine_monotherapy|Azacitidine]] | |[[#Azacitidine_monotherapy|Azacitidine]] | ||
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===References=== | ===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. [http://ascopubs.org/doi/ | + | # 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. [http://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/28486043 PubMed] |
=Maintenance after first-line therapy= | =Maintenance after first-line therapy= |
Revision as of 04:13, 19 December 2017
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7 regimens on this page
10 variants on this page
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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