Use of Azacitidine or Decitabine for the Up-Front Setting in Acute Myeloid Leukaemia: A Systematic Review and Meta-Analysis
Irruption of decitabine and azacitidine has led to profound changes in the upfront management of older acute myeloid leukaemia (AML). However, they have not been directly compared in a randomised clinical trial. In addition, there are no studies comparing the optimal treatment schedule of each drug...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-11-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/22/5677 |
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| author | Miriam Saiz-Rodríguez Jorge Labrador Beatriz Cuevas David Martínez-Cuadrón Verónica Campuzano Raquel Alcaraz Isabel Cano Miguel A. Sanz Pau Montesinos |
| author_facet | Miriam Saiz-Rodríguez Jorge Labrador Beatriz Cuevas David Martínez-Cuadrón Verónica Campuzano Raquel Alcaraz Isabel Cano Miguel A. Sanz Pau Montesinos |
| author_sort | Miriam Saiz-Rodríguez |
| collection | DOAJ |
| description | Irruption of decitabine and azacitidine has led to profound changes in the upfront management of older acute myeloid leukaemia (AML). However, they have not been directly compared in a randomised clinical trial. In addition, there are no studies comparing the optimal treatment schedule of each drug in AML. A systematic review and meta-analysis on the efficacy of decitabine and azacitidine monotherapy in newly diagnosed AML was conducted. Randomised controlled trials and retrospective studies were included. A total of 2743 patients from 23 cohorts were analysed (10 cohorts of azacitidine and 13 of decitabine). Similar response rates were observed for azacitidine (38%, 95% CI: 30–47%) compared to decitabine (40%, 95% CI: 32–48%) (<i>p</i> = 0.825). Overall survival (OS) between azacitidine (10.04 months, 95% CI: 8.36–11.72) and decitabine (8.79 months, 95% CI: 7.62–9.96) was also similar (<i>p</i> = 0.386). Patients treated with azacitidine showed a lower median OS when azacitidine was administered for 5 days (6.28 months, 95% CI: 4.23–8.32) compared to the standard 7-day schedule (10.83 months, 95% CI: 9.07–12.59, <i>p</i> = 0.002). Among patients treated with decitabine, response rates and OS were not significantly different between 5-day and 10-day decitabine regimens. Despite heterogeneity between studies, we found no differences in response rates and OS in AML patients treated with azacitidine or decitabine. |
| first_indexed | 2024-03-10T05:38:41Z |
| format | Article |
| id | doaj.art-c2d01b7cf4a649cfac3c23bf43700bdb |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T05:38:41Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-c2d01b7cf4a649cfac3c23bf43700bdb2023-11-22T22:41:41ZengMDPI AGCancers2072-66942021-11-011322567710.3390/cancers13225677Use of Azacitidine or Decitabine for the Up-Front Setting in Acute Myeloid Leukaemia: A Systematic Review and Meta-AnalysisMiriam Saiz-Rodríguez0Jorge Labrador1Beatriz Cuevas2David Martínez-Cuadrón3Verónica Campuzano4Raquel Alcaraz5Isabel Cano6Miguel A. Sanz7Pau Montesinos8Research Unit, Fundación Burgos por la Investigación de la Salud (FBIS), Hospital Universitario de Burgos, 09006 Burgos, SpainResearch Unit, Fundación Burgos por la Investigación de la Salud (FBIS), Hospital Universitario de Burgos, 09006 Burgos, SpainHematology Department, Hospital Universitario de Burgos, 09006 Burgos, SpainHematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, SpainHematology Department, Hospital Universitario de Burgos, 09006 Burgos, SpainResearch Unit, Fundación Burgos por la Investigación de la Salud (FBIS), Hospital Universitario de Burgos, 09006 Burgos, SpainHematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, SpainHematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, SpainHematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, SpainIrruption of decitabine and azacitidine has led to profound changes in the upfront management of older acute myeloid leukaemia (AML). However, they have not been directly compared in a randomised clinical trial. In addition, there are no studies comparing the optimal treatment schedule of each drug in AML. A systematic review and meta-analysis on the efficacy of decitabine and azacitidine monotherapy in newly diagnosed AML was conducted. Randomised controlled trials and retrospective studies were included. A total of 2743 patients from 23 cohorts were analysed (10 cohorts of azacitidine and 13 of decitabine). Similar response rates were observed for azacitidine (38%, 95% CI: 30–47%) compared to decitabine (40%, 95% CI: 32–48%) (<i>p</i> = 0.825). Overall survival (OS) between azacitidine (10.04 months, 95% CI: 8.36–11.72) and decitabine (8.79 months, 95% CI: 7.62–9.96) was also similar (<i>p</i> = 0.386). Patients treated with azacitidine showed a lower median OS when azacitidine was administered for 5 days (6.28 months, 95% CI: 4.23–8.32) compared to the standard 7-day schedule (10.83 months, 95% CI: 9.07–12.59, <i>p</i> = 0.002). Among patients treated with decitabine, response rates and OS were not significantly different between 5-day and 10-day decitabine regimens. Despite heterogeneity between studies, we found no differences in response rates and OS in AML patients treated with azacitidine or decitabine.https://www.mdpi.com/2072-6694/13/22/5677azacitidinedecitabinemeta-analysisacute myeloid leukaemiaelderly |
| spellingShingle | Miriam Saiz-Rodríguez Jorge Labrador Beatriz Cuevas David Martínez-Cuadrón Verónica Campuzano Raquel Alcaraz Isabel Cano Miguel A. Sanz Pau Montesinos Use of Azacitidine or Decitabine for the Up-Front Setting in Acute Myeloid Leukaemia: A Systematic Review and Meta-Analysis Cancers azacitidine decitabine meta-analysis acute myeloid leukaemia elderly |
| title | Use of Azacitidine or Decitabine for the Up-Front Setting in Acute Myeloid Leukaemia: A Systematic Review and Meta-Analysis |
| title_full | Use of Azacitidine or Decitabine for the Up-Front Setting in Acute Myeloid Leukaemia: A Systematic Review and Meta-Analysis |
| title_fullStr | Use of Azacitidine or Decitabine for the Up-Front Setting in Acute Myeloid Leukaemia: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Use of Azacitidine or Decitabine for the Up-Front Setting in Acute Myeloid Leukaemia: A Systematic Review and Meta-Analysis |
| title_short | Use of Azacitidine or Decitabine for the Up-Front Setting in Acute Myeloid Leukaemia: A Systematic Review and Meta-Analysis |
| title_sort | use of azacitidine or decitabine for the up front setting in acute myeloid leukaemia a systematic review and meta analysis |
| topic | azacitidine decitabine meta-analysis acute myeloid leukaemia elderly |
| url | https://www.mdpi.com/2072-6694/13/22/5677 |
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