Continued Treatment with Dacogen™ May Be Superior to Retreatment in MDS

Continued Treatment with Dacogen™ May Be Superior to Retreatment in MDS

According to results published in an early online edition of the journal Cancer, retreatment with Dacogen (decitabine) upon disease progression provides significant anticancer responses. However, responses when disease has progressed are less favorable than initial responses with decitabine.

Myelodysplastic syndromes are a group of blood (hematologic) disorders that are diagnosed in 10,00020,000 individuals annually in the US. MDS occurs when immature blood cells do not mature properly and are never able to perform their intended function. They instead crowd out normal blood cells in the bone marrow, often inhibiting other cells from performing their intended functions.

MDS can also develop into an aggressive form of leukemia, acute myelogenous leukemia (AML). Preventing or delaying the development of MDS into AML is an important consideration since long-term survival for AML is not favorable.

Standard treatment for MDS can include therapies ranging from observation and supportive care to an aggressive stem cell transplant. Choice of therapies depends on the extent or aggressiveness of the disease as well as the patients medical condition and age. Vidaza® and Revlimid® are new agents that have recently been approved for the treatment of MDS; clinical trials evaluating various agents for the treatment of MDS are ongoing.

Decitabine is an agent that is not yet approved by the FDA; however, the FDA plans a review of decitabine in May of 2006. Decitabine provides anticancer activity by disrupting cellular processes so that cancer cells stop growing.

Researchers from Germany recently evaluated data from three clinical trials regarding the effectiveness of retreatment with decitabine following disease progression in patients with MDS. The data included 22 patients with MDS who had received prior therapy with decitabine and experienced subsequent cancer progression. Upon progression, the patients were retreated with decitabine.

  • Retreatment with decitabine provided inferior results compared to initial treatment with decitabine.
  • Anticancer responses were achieved in 45% of patients with retreatment of decitabine; 55% of patients did not respond to retreatment with decitabine.
  • The median time of response was 4 months with retreatment with decitabine.
  • The median time of response had been 10 months with initial treatment with decitabine.

The researchers concluded that continued treatment with decitabine may provide superior results compared to retreatment upon disease progression in patients with MDS. However, further studies are necessary to determine optimal scheduling of decitabine and to directly compare continuous treatment to retreatment in these patients.

Patients diagnosed with MDS may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating optimal scheduling of decitabine or other promising therapeutic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.

Reference: Ruter B, Wijermans P, Lubbert M, et al. Superiority of Prolonged Low-Dose Azanucleoside Administration? Cancer. Early on-line publication. 2006. DOI: 10.1002/cncr 21796.

Related News:Decitabine Improves Outcomes in Myelodysplastic Syndromes (3/14/06)

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