Real-world Effectiveness of Azacitidine in Treatment-Naive Patients With Higher-risk Myelodysplastic Syndromes

Rajakumaraswamy, N; Gandhi, M; Wei, AH; Sallman, DA; Daver, NG; Mo, S; Iqbal, S; Karalliyadda, R; Chen, M; Wang, Y; Vyas, P

Author(s): Rajakumaraswamy, N; Gandhi, M; Wei, AH; Sallman, DA; Daver, NG; Mo, S; Iqbal, S; Karalliyadda, R; Chen, M; Wang, Y; Vyas, P;
Details: Publication Year 2024-04,Volume 24,Issue #4,Page 260-268.e2
Journal Title: Clinical Lymphoma, Myeloma & Leukemia
Publication Type: Research article
Abstract: INTRODUCTION: Azacitidine (AZA) is an approved frontline therapy for higher-risk myelodysplastic syndromes (HR-MDS); however, poor survival denotes unmet needs to increase depth/duration of response (DOR). METHODS: This retrospective study with patient chart review evaluated AZA effectiveness in 382 treatment-naive patients with HR-MDS from a US electronic health record (EHR)-derived database. Responses were assessed using International Working Group (IWG) 2006 criteria; real-world equivalents were derived from EHRs. Primary endpoint was IWG 2006-based complete remission rate (CRR). Secondary endpoints were EHR-based CRR, IWG 2006- and EHR-based objective response rates (ORRs), duration of CR, DOR, progression-free survival, time-to-next-treatment, and overall survival (OS). RESULTS: Using IWG 2006 criteria, the CRR was 7.9% (n = 30); median duration of CR was 12.0 months (95% CI, 7.7-15.6). In poor cytogenetic risk (n = 101) and TP53 mutation (n = 46) subgroups, CRRs were 7.9% (n = 8) and 8.7% (n = 4), respectively. ORR was 62.8% (n = 240), including a hematologic improvement rate (HIR) of 46.9% (n = 179). Using EHR-based data, CRR was 3.7% (n = 14); median duration of CR was 13.5 months (95% CI, 4.5-21.5). ORR was 67.8% (n = 259), including an HIR of 29.3% (n = 112). Median follow-up was 12.9 months; median OS was 17.9 months (95% CI, 15.5-21.7). CONCLUSIONS: Consistent with other studies, CRRs and median OS with AZA in treatment-naive patients with HR-MDS were low in this large, real-world cohort. Novel agents/combinations are urgently needed to improve these outcomes in HR-MDS.
Publisher: Elsevier
Keywords: Humans; *Azacitidine/pharmacology/therapeutic use; Antimetabolites, Antineoplastic/pharmacology/therapeutic use; *Myelodysplastic Syndromes/genetics; Retrospective Studies; Mutation; Treatment Outcome; Hr-mds; Mds; Real-world data
Department(s): Clinical Haematology
Publisher's Version: https://doi.org/10.1016/j.clml.2023.12.008
Open Access at Publisher's Site: https://doi.org/10.1016/j.clml.2023.12.008
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-07-17 07:24:17

Last Modified: 2024-07-17 07:24:25