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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Autores principales:	Miriam Saiz-Rodríguez, Jorge Labrador, Beatriz Cuevas, David Martínez-Cuadrón, Verónica Campuzano, Raquel Alcaraz, Isabel Cano, Miguel A. Sanz, Pau Montesinos
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	azacitidine decitabine meta-analysis acute myeloid leukaemia elderly Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/c2d01b7cf4a649cfac3c23bf43700bdb
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spelling	oai:doaj.org-article:c2d01b7cf4a649cfac3c23bf43700bdb2021-11-25T17:02:33ZUse of Azacitidine or Decitabine for the Up-Front Setting in Acute Myeloid Leukaemia: A Systematic Review and Meta-Analysis10.3390/cancers132256772072-6694https://doaj.org/article/c2d01b7cf4a649cfac3c23bf43700bdb2021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5677https://doaj.org/toc/2072-6694Irruption 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.Miriam Saiz-RodríguezJorge LabradorBeatriz CuevasDavid Martínez-CuadrónVerónica CampuzanoRaquel AlcarazIsabel CanoMiguel A. SanzPau MontesinosMDPI AGarticleazacitidinedecitabinemeta-analysisacute myeloid leukaemiaelderlyNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5677, p 5677 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	azacitidine decitabine meta-analysis acute myeloid leukaemia elderly Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	azacitidine decitabine meta-analysis acute myeloid leukaemia elderly Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 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
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.
format	article
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
title	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_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_sort	use of azacitidine or decitabine for the up-front setting in acute myeloid leukaemia: a systematic review and meta-analysis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/c2d01b7cf4a649cfac3c23bf43700bdb
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Use of Azacitidine or Decitabine for the Up-Front Setting in Acute Myeloid Leukaemia: A Systematic Review and Meta-Analysis

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