Myelodysplastic syndrome
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24 regimens on this page
43 variants on this page
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Untreated
Alemtuzumab (Campath)
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Indication: Intermediate-1 MDS (RAEB-I, RA, or RARS)
Regimen
Phase II
- Alemtuzumab (Campath) 1 mg IV once on day 1; then 10 mg IV once per day on days 2 to 11
Supportive Medications:
- Pentamidine (Nebupent) dose not specified INH monthly for at least 6 months for PCP prophylaxis
- Valacyclovir (Valtrex) dose/schedule not specified until CD4 count >200/uL
- Ciprofloxacin (Cipro) dose/schedule not specified if ANC <500/uL
- Erythropoietin and G-CSF were permitted for severe anemia or neutropenia
11-day course of therapy
References
- Sloand EM, Olnes MJ, Shenoy A, Weinstein B, Boss C, Loeliger K, Wu CO, More K, Barrett AJ, Scheinberg P, Young NS. Alemtuzumab treatment of intermediate-1 myelodysplasia patients is associated with sustained improvement in blood counts and cytogenetic remissions. J Clin Oncol. 2010 Dec 10;28(35):5166-73. Epub 2010 Nov 1. link to original article contains verified protocol PubMed
Antithymocyte globulin (ATG)
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Regimen
Phase II
- Antithymocyte globulin (ATG) 40 mg/kg IV over 4 to 8 hours on days 1 to 4
- Prednisone (Sterapred) 1 mg/kg (minimum of 40 mg) PO total dose on days 1 to 10, and then tapered to off during days 11 to 17
References
- Molldrem JJ, Caples M, Mavroudis D, Plante M, Young NS, Barrett AJ. Antithymocyte globulin for patients with myelodysplastic syndrome. Br J Haematol. 1997 Dec;99(3):699-705. PubMed
- Molldrem JJ, Leifer E, Bahceci E, Saunthararajah Y, Rivera M, Dunbar C, Liu J, Nakamura R, Young NS, Barrett AJ. Antithymocyte globulin for treatment of the bone marrow failure associated with myelodysplastic syndromes. Ann Intern Med. 2002 Aug 6;137(3):156-63. link to original article contains protocol PubMed
- Steensma DP, Dispenzieri A, Moore SB, Schroeder G, Tefferi A. Antithymocyte globulin has limited efficacy and substantial toxicity in unselected anemic patients with myelodysplastic syndrome. Blood. 2003 Mar 15;101(6):2156-8. Epub 2002 Oct 31. link to original article contains protocol PubMed
- Sloand EM, Wu CO, Greenberg P, Young N, Barrett J. Factors affecting response and survival in patients with myelodysplasia treated with immunosuppressive therapy. J Clin Oncol. 2008 May 20;26(15):2505-11. Epub 2008 Apr 14. link to original article PubMed
Azacitidine (Vidaza)
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Regimen #1
Study | Evidence | Comparator |
Silverman et al. 2002 (CALGB 8421, 8921, & 9921) | Phase III | Best supportive care |
Fenaux et al. 2009 | Phase III | Best supportive care |
- Azacitidine (Vidaza) 75 mg/m2 SC or IV continuous infusion on days 1 to 7
28-day cycles, given for at least 4 cycles, then depending on study, continued for 3 cycles beyond complete remission, or if there was progressive disease or unacceptable toxicity
Regimen #2, Fili et al. 2013
Phase II
Intended to be used for low-risk MDS patients who are symptomatic or intolerant to erythropoietin
- Azacitidine (Vidaza) 75 mg/m2 SC once per day on days 1 to 5
Supportive medications:
- G-CSF or GM-CSF was allowed if ANC < 200 and/or systemic infection
- Erythropoiesis-stimulating agents were not allowed
- Antimicrobial and antifungal prophylaxis (agents not specified) given if ANC < 500
28-day cycle x 8 cycles
Regimen #3, Grövdal et al. 2010
Phase II
Intended to be used for high-risk MDS patients in remission after induction therapy
- Azacitidine (Vidaza) 60 mg/m2 SC once per day on days 1 to 5
28-day cycles
References
- Silverman LR, Demakos EP, Peterson BL, Kornblith AB, Holland JC, Odchimar-Reissig R, Stone RM, Nelson D, Powell BL, DeCastro CM, Ellerton J, Larson RA, Schiffer CA, Holland JF. Randomized controlled trial of azacitidine in patients with the myelodysplastic syndrome: a study of the cancer and leukemia group B. J Clin Oncol. 2002 May 15;20(10):2429-40. link to original article contains verified protocol PubMed
- Update: Silverman LR, McKenzie DR, Peterson BL, Holland JF, Backstrom JT, Beach CL, Larson RA; Cancer and Leukemia Group B. Further analysis of trials with azacitidine in patients with myelodysplastic syndrome: studies 8421, 8921, and 9221 by the Cancer and Leukemia Group B. J Clin Oncol. 2006 Aug 20;24(24):3895-903. link to original article contains protocol PubMed
- Fenaux P, Mufti GJ, Hellstrom-Lindberg E, Santini V, Finelli C, Giagounidis A, Schoch R, Gattermann N, Sanz G, List A, Gore SD, Seymour JF, Bennett JM, Byrd J, Backstrom J, Zimmerman L, McKenzie D, Beach C, Silverman LR; International Vidaza High-Risk MDS Survival Study Group. Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes: a randomised, open-label, phase III study. Lancet Oncol. 2009 Mar;10(3):223-32. Epub 2009 Feb 21. link to original article contains protocol PubMed
- 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
- Filì C, Malagola M, Follo MY, Finelli C, Iacobucci I, Martinelli G, Cattina F, Clissa C, Candoni A, Fanin R, Gobbi M, Bocchia M, Defina M, Spedini P, Skert C, Manzoli L, Cocco L, Russo D. Prospective phase II Study on 5-days azacitidine for treatment of symptomatic and/or erythropoietin unresponsive patients with low/INT-1-risk myelodysplastic syndromes. Clin Cancer Res. 2013 Jun 15;19(12):3297-308. link to original article contains verified protocol PubMed
Azacitidine & Lenalidomide
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Regimen
Phase II
- Azacitidine (Vidaza) 75 mg/m2 IV once per day on days 1 to 5
- Lenalidomide (Revlimid) 10mg PO once per day on days 1 to 21
28-day cycles up to 7 cycles, with option to continue single agent azacitidine per MD discretion
References
- Sekeres MA, Tiu RV, Komrokji R, Lancet J, Advani AS, Afable M, Englehaupt R, Juersivich J, Cuthbertson D, Paleveda J, Tabarroki A, Visconte V, Makishima H, Jerez A, Paquette R, List AF, Maciejewski JP. Phase 2 study of the lenalidomide and azacitidine combination in patients with higher-risk myelodysplastic syndromes. Blood. 2012 Dec 13;120(25):4945-51. Epub 2012 Aug 22. link to original article contains protocol PubMed
Azacitidine & Vorinostat
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Regimen
Phase II
Three different schedules were evaluated; a randomized trial is underway using the doses from schedule two.
Schedule One
- Azacitidine (Vidaza) 55 mg/m2 SC once per day on days 1 to 7
- Vorinostat (Zolinza) 400 mg PO once per day on days 3 to 16
Schedule Two
- Azacitidine (Vidaza) 75 mg/m2 SC once per day on days 1 to 7
- Vorinostat (Zolinza) 600 mg PO once per day on days 3 to 9
Schedule Three
- Azacitidine (Vidaza) 55 mg/m2 SC once per day on days 1 to 7
- Vorinostat (Zolinza) 400 mg PO once per day on days 3 to 9
28-day cycles
References
- Abstract: Amit Verma, Rosalie Odchimar-Reissig, Eric J. Feldman, Shyamala C. Navada, Erin P Demakos, Maria R. Baer, Vesna Najfeld, Joseph A Sparano, Richard Piekarz. A Phase II Trial Of Epigenetic Modulators Vorinostat In Combination With Azacitidine (azaC) In Patients With The Myelodysplastic Syndrome (MDS): Initial Results Of Study 6898 Of The New York Cancer Consortium. Blood Nov 2013,122(21)386 link to original abstract
Best supportive care
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Regimen
Study | Evidence | Comparator |
Silverman et al. 2002 (CALGB 8421, 8921, & 9921) | Phase III | Azacitidine |
Kantarjian et al. 2006 | Phase III | Decitabine |
Fenaux et al. 2009 | Phase III | Azacitidine |
Lübbert et al. 2011 | Phase III | Decitabine |
No active antineoplastic therapy; included here because it was a comparator arm in several studies.
References
- Silverman LR, Demakos EP, Peterson BL, Kornblith AB, Holland JC, Odchimar-Reissig R, Stone RM, Nelson D, Powell BL, DeCastro CM, Ellerton J, Larson RA, Schiffer CA, Holland JF. Randomized controlled trial of azacitidine in patients with the myelodysplastic syndrome: a study of the cancer and leukemia group B. J Clin Oncol. 2002 May 15;20(10):2429-40. link to original article contains verified protocol PubMed
- Update: Silverman LR, McKenzie DR, Peterson BL, Holland JF, Backstrom JT, Beach CL, Larson RA; Cancer and Leukemia Group B. Further analysis of trials with azacitidine in patients with myelodysplastic syndrome: studies 8421, 8921, and 9221 by the Cancer and Leukemia Group B. J Clin Oncol. 2006 Aug 20;24(24):3895-903. link to original article contains protocol PubMed
- Kantarjian H, Issa JP, Rosenfeld CS, Bennett JM, Albitar M, DiPersio J, Klimek V, Slack J, de Castro C, Ravandi F, Helmer R 3rd, Shen L, Nimer SD, Leavitt R, Raza A, Saba H. Decitabine improves patient outcomes in myelodysplastic syndromes: results of a phase III randomized study. Cancer. 2006 Apr 15;106(8):1794-803. link to original article contains protocol PubMed
- Fenaux P, Mufti GJ, Hellstrom-Lindberg E, Santini V, Finelli C, Giagounidis A, Schoch R, Gattermann N, Sanz G, List A, Gore SD, Seymour JF, Bennett JM, Byrd J, Backstrom J, Zimmerman L, McKenzie D, Beach C, Silverman LR; International Vidaza High-Risk MDS Survival Study Group. Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes: a randomised, open-label, phase III study. Lancet Oncol. 2009 Mar;10(3):223-32. Epub 2009 Feb 21. link to original article contains protocol PubMed content property of HemOnc.org
- Lübbert M, Suciu S, Baila L, Rüter BH, Platzbecker U, Giagounidis A, Selleslag D, Labar B, Germing U, Salih HR, Beeldens F, Muus P, Pflüger KH, Coens C, Hagemeijer A, Eckart Schaefer H, Ganser A, Aul C, de Witte T, Wijermans PW. Low-dose decitabine versus best supportive care in elderly patients with intermediate- or high-risk myelodysplastic syndrome (MDS) ineligible for intensive chemotherapy: final results of the randomized phase III study of the European Organisation for Research and Treatment of Cancer Leukemia Group and the German MDS Study Group. J Clin Oncol. 2011 May 20;29(15):1987-96. Epub 2011 Apr 11. link to original article contains verified protocol PubMed
Clofarabine (Clolar)
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Regimen #1
Study | Evidence | Comparator |
Faderl et al. 2012 | Randomized Phase II | Clofarabine 30 mg/m2 dosing |
This randomized trial tested two doses of clofarabine, 15 mg/m2 and 30 mg/m2. Lower dose was less toxic and clinical activity was comparable
- Clofarabine (Clolar) 15 mg/m2 IV over 1 hour once per day on days 1 to 5
Supportive medications:
- "Supportive care measures such as antibiotic prophylaxis (eg, levofloxacin, valacyclovir, and itraconazole or voriconazole), hematopoietic growth factors, and transfusions were provided as necessitated for optimal medical care of the patients." In order to decrease risk of liver function abnormalities, no antifungals were given on the days where clofarabine was given.
4 to 8 week cycle x up to 12 cycles
Regimen #2
Study | Evidence |
Faderl et al. 2010 | Non-randomized |
Initial dose was too toxic; 20 mg/m2 was final dose level
- Clofarabine (Clolar) 20 mg/m2 PO once per day on days 1 to 5
Supportive medications:
- "Supportive care included anti-infectious prophylaxis (eg, levaquin, valacyclovir, and itraconazole or voriconazole), hematopoietic growth factors, and transfusions as judged indicated by the treating physician." In order to decrease risk of liver function abnormalities, no antifungals were given on the days where clofarabine was given.
4 to 8 week cycle x up to 12 cycles
References
- Faderl S, Garcia-Manero G, Estrov Z, Ravandi F, Borthakur G, Cortes JE, O'Brien S, Gandhi V, Plunkett W, Byrd A, Kwari M, Kantarjian HM. Oral clofarabine in the treatment of patients with higher-risk myelodysplastic syndrome. J Clin Oncol. 2010 Jun 1;28(16):2755-60. Epub 2010 Apr 26. link to original article contains verified protocol PubMed
- Faderl S, Garcia-Manero G, Jabbour E, Ravandi F, Borthakur G, Estrov Z, Gandhi V, Byrd AL, Kwari M, Cortes J, Kantarjian HM. A randomized study of 2 dose levels of intravenous clofarabine in the treatment of patients with higher-risk myelodysplastic syndrome. Cancer. 2012 Feb 1;118(3):722-8. Epub 2011 Jul 12. link to original article contains verified protocol PubMed
Cyclosporine modified (Neoral)
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Regimen
Pilot, <20 patients reported
- Cyclosporine modified (Neoral) 5 to 6 mg/kg/day, divided into two equal doses PO BID, adjusted to maintain therapeutic cyclosporine level of 100 to 300 ng/mL
References
- Jonásova A, Neuwirtová R, Cermák J, Vozobulová V, Mociková K, Sisková M, Hochová I. Cyclosporin A therapy in hypoplastic MDS patients and certain refractory anaemias without hypoplastic bone marrow. Br J Haematol. 1998 Feb;100(2):304-9. link to original article contains protocol PubMed
- Sloand EM, Wu CO, Greenberg P, Young N, Barrett J. Factors affecting response and survival in patients with myelodysplasia treated with immunosuppressive therapy. J Clin Oncol. 2008 May 20;26(15):2505-11. Epub 2008 Apr 14. link to original article PubMed
Decitabine (Dacogen)
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Regimen #1
Study | Evidence | Comparator | |
Kantarjian et al. 2007 | Randomized Phase II | Decitabine IV Decitabine SC | |
Issa et al. 2014 | Randomized Phase II | Decitabine & Valproic acid |
In Kantarjian et al. 2007, this was preferred due to higher complete response rate over the 5-day SC or 10-day IV regimens.
- Decitabine (Dacogen) 20 mg/m2 IV over 1 hour once per day on days 1 to 5
4- to 6-week cycles
Regimen #2
Study | Evidence | Comparator |
Kantarjian et al. 2006 | Phase III | Best supportive care |
Lübbert et al. 2011 | Phase III | Best supportive care |
- Decitabine (Dacogen) 15 mg/m2 IV over 3 to 4 hours every 8 hours on days 1 to 3
6-week cycle x up to 10 cycles, depending on the protocol
Regimen #3
Study | Evidence | Comparator |
Kantarjian et al. 2007 | Randomized Phase II, <20 in this arm | Decitabine IV |
In Kantarjian et al. 2007, the 5-day IV regimen was preferred due to higher complete response rate over this or the 10-day IV regimen.
- Decitabine (Dacogen) 20 mg/m2/day divided into 2 SC doses per day on days 1 to 5
28-day cycles
Regimen #4
Study | Evidence | Comparator |
Kantarjian et al. 2007 | Randomized Phase II, <20 in this arm | Decitabine IV Decitabine SC |
In Kantarjian et al. 2007, the 5-day IV regimen was preferred due to higher complete response rate over this or the 5-day SC regimen.
- Decitabine (Dacogen) 10 mg/m2 IV over 1 hour once per day on days 1 to 10
28-day cycles
Regimen #5, Garcia-Manero et al. 2013
Phase II
- Decitabine (Dacogen) 20 mg/m2 SC once per day on days 1 to 3
28-day cycles +/- 3 days x up to 12 months
Regimen #6, Garcia-Manero et al. 2013
Phase II
- Decitabine (Dacogen) 20 mg/m2 SC once per week on days 1, 8, 15
28-day cycles +/- 3 days x up to 12 months
References
- Kantarjian H, Issa JP, Rosenfeld CS, Bennett JM, Albitar M, DiPersio J, Klimek V, Slack J, de Castro C, Ravandi F, Helmer R 3rd, Shen L, Nimer SD, Leavitt R, Raza A, Saba H. Decitabine improves patient outcomes in myelodysplastic syndromes: results of a phase III randomized study. Cancer. 2006 Apr 15;106(8):1794-803. link to original article contains protocol PubMed
- Kantarjian H, Oki Y, Garcia-Manero G, Huang X, O'Brien S, Cortes J, Faderl S, Bueso-Ramos C, Ravandi F, Estrov Z, Ferrajoli A, Wierda W, Shan J, Davis J, Giles F, Saba HI, Issa JP. Results of a randomized study of 3 schedules of low-dose decitabine in higher-risk myelodysplastic syndrome and chronic myelomonocytic leukemia. Blood. 2007 Jan 1;109(1):52-7. Epub 2006 Aug 1. link to original article contains protocol PubMed
- Lübbert M, Suciu S, Baila L, Rüter BH, Platzbecker U, Giagounidis A, Selleslag D, Labar B, Germing U, Salih HR, Beeldens F, Muus P, Pflüger KH, Coens C, Hagemeijer A, Eckart Schaefer H, Ganser A, Aul C, de Witte T, Wijermans PW. Low-dose decitabine versus best supportive care in elderly patients with intermediate- or high-risk myelodysplastic syndrome (MDS) ineligible for intensive chemotherapy: final results of the randomized phase III study of the European Organisation for Research and Treatment of Cancer Leukemia Group and the German MDS Study Group. J Clin Oncol. 2011 May 20;29(15):1987-96. Epub 2011 Apr 11. link to original article contains verified protocol PubMed
- Garcia-Manero G, Jabbour E, Borthakur G, Faderl S, Estrov Z, Yang H, Maddipoti S, Godley LA, Gabrail N, Berdeja JG, Nadeem A, Kassalow L, Kantarjian H. Randomized Open-Label Phase II Study of Decitabine in Patients With Low- or Intermediate-Risk Myelodysplastic Syndromes. J Clin Oncol. 2013 Jun 3. [Epub ahead of print] link to original article contains verified protocol PubMed
- Issa JP, Garcia-Manero G, Huang X, Cortes J, Ravandi F, Jabbour E, Borthakur G, Brandt M, Pierce S, Kantarjian HM. Results of phase 2 randomized study of low-dose decitabine with or without valproic acid in patients with myelodysplastic syndrome and acute myelogenous leukemia. Cancer. 2015 Feb 15;121(4):556-61. Epub 2014 Oct 21. link to original article contains verified protocol PubMed
Epoetin alfa & Lenalidomide
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Phase II
Regimen
- Lenalidomide (Revlimid) 10 to 15 mg PO once per day
For 16 weeks; erythroid nonresponders or those with relapsed anemia then offered combined treatment:
- Epoetin alfa (Procrit) 40,000 units SC once per week
- Lenalidomide (Revlimid) 10 to 15 mg PO once per day
Continue until treatment failure or limiting toxicity
References
- Komrokji RS, Lancet JE, Swern AS, Chen N, Paleveda J, Lush R, Saba HI, List AF. Combined treatment with lenalidomide and epoetin alfa in lower-risk patients with myelodysplastic syndrome. Blood. 2012 Oct 25;120(17):3419-24. Epub 2012 Aug 30. link to original article contains protocol PubMed
Lenalidomide (Revlimid)
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Regimen
Phase II
- Lenalidomide (Revlimid) 10 mg PO once per day
References
- List A, Kurtin S, Roe DJ, Buresh A, Mahadevan D, Fuchs D, Rimsza L, Heaton R, Knight R, Zeldis JB. Efficacy of lenalidomide in myelodysplastic syndromes. N Engl J Med. 2005 Feb 10;352(6):549-57. link to original article PubMed
- List A, Dewald G, Bennett J, Giagounidis A, Raza A, Feldman E, Powell B, Greenberg P, Thomas D, Stone R, Reeder C, Wride K, Patin J, Schmidt M, Zeldis J, Knight R; Myelodysplastic Syndrome-003 Study Investigators. Lenalidomide in the myelodysplastic syndrome with chromosome 5q deletion. N Engl J Med. 2006 Oct 5;355(14):1456-65. link to original article contains protocol PubMed
- Raza A, Reeves JA, Feldman EJ, Dewald GW, Bennett JM, Deeg HJ, Dreisbach L, Schiffer CA, Stone RM, Greenberg PL, Curtin PT, Klimek VM, Shammo JM, Thomas D, Knight RD, Schmidt M, Wride K, Zeldis JB, List AF. Phase 2 study of lenalidomide in transfusion-dependent, low-risk, and intermediate-1 risk myelodysplastic syndromes with karyotypes other than deletion 5q. Blood. 2008 Jan 1;111(1):86-93. Epub 2007 Sep 24. link to original article contains protocol PubMed
Rabbit ATG (Thymoglobulin)
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Regimen
Phase II
- Rabbit ATG (Thymoglobulin) 2.5 mg/kg IV over at least 6 hours once per day on days 1 to 4
Supportive medications:
- Prednisone (Sterapred) 1 mg/kg/day PO, started 2 days before first rabbit ATG (Thymoglobulin) and continued at full dose during the 4 days, then tapered over the subsequent 14 days (tapering schedule not described)
- Antibiotics per local practices
References
- Komrokji RS, Mailloux AW, Chen DT, Sekeres MA, Paquette R, Fulp WJ, Sugimori C, Paleveda-Pena J, Maciejewski JP, List AF, Epling-Burnette PK. A phase 2 multicenter rabbit anti-thymocyte globulin trial in patients with myelodysplastic syndromes identifying a novel model for response prediction. Haematologica. 2014 Jan 31. [Epub ahead of print] link to original article contains verified protocol PubMed
Temozolomide (Temodar)
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Regimen, Brandwein et al. 2014
Phase II
Patient selection was based on MGMT expression by Western blot. See article for details.
- Temozolomide (Temodar) 200 mg/m2/day PO on days 1 to 7; complete responders could receive 200 mg/m2/day PO on days 1 to 5
28-day cycle x up to 12 cycles
References
- Brandwein JM, Kassis J, Leber B, Hogge D, Howson-Jan K, Minden MD, Galarneau A, Pouliot JF. Phase II study of targeted therapy with temozolomide in acute myeloid leukaemia and high-risk myelodysplastic syndrome patients pre-screened for low O(6) -methylguanine DNA methyltransferase expression. Br J Haematol. 2014 Dec;167(5):664-70. Epub 2014 Aug 27. link to original article contains protocol PubMed
Relapsed/Refractory
Erlotinib (Tarceva)
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Regimen, Komrokji et al. 2014; Thepot et al. 2014
Phase II
This is the MTD in this dose-escalation trial.
- Erlotinib (Tarceva) 150 mg PO once per day
References
- Komrokji RS, Padron E, Yu D, Fulp WJ, Rodriguez Y, Tinsley S, List AF, Lancet JE. Phase II clinical study of erlotinib for treatment of myelodysplastic syndromes. Am J Hematol. 2014 Aug;89(8):809-12. Epub 2014 May 16. link to full article PubMed
- Thepot S, Boehrer S, Seegers V, Prebet T, Beyne-Rauzy O, Wattel E, Delaunay J, Raffoux E, Hunault M, Jourdan E, Chermat F, Sebert M, Kroemer G, Fenaux P, Adès L; Groupe Francophone des Myelodysplasies (GFM). A phase I/II trial of Erlotinib in higher risk myelodysplastic syndromes and acute myeloid leukemia after azacitidine failure. Leuk Res. 2014 Dec;38(12):1430-4. Epub 2014 Oct 7. link to original article PubMed
Links
- IPSS (BloodRef.com)
- IPSS (Medscape)
- IPSS-R (BloodRef.com)
- IPSS-R calculator, Revised International Prognostic Scoring System calculator (mds-foundation.org)
- Advanced IPSS-R calculator, Revised International Prognostic Scoring System calculator (mds-foundation.org)
- WHO classification-based prognostic scoring system (BloodRef.com)