PMID- 37170899
OWN - NLM
STAT- MEDLINE
DCOM- 20230602
LR  - 20230602
IS  - 1744-8301 (Electronic)
IS  - 1479-6694 (Linking)
VI  - 19
IP  - 11
DP  - 2023 Apr
TI  - Therapies for acute myeloid leukemia in patients ineligible for standard 
      induction chemotherapy: a systematic review.
PG  - 789-810
LID - 10.2217/fon-2022-1286 [doi]
AB  - Aim: To review clinical evidence for current and emerging treatments for patients 
      with acute myeloid leukemia (AML) who are ineligible for first-line induction 
      chemotherapy. Methods: A systematic literature review was performed (28 October 
      2021) to identify clinical outcomes including overall survival (OS), event-free 
      survival (EFS), relapse-free survival (RFS) and adverse events (AEs). Results: Of 
      233 references that met prespecified criteria, 26 studies were included. Adding 
      targeted therapies (venetoclax/ivosidenib) to hypomethylating agents (HMAs) 
      yielded better OS hazard ratios (HRs) (0.44-0.66) and EFS HRs (0.33-0.63) 
      compared with other agents. AEs were more frequent with combination therapies 
      than control arms, except with ivosidenib plus azacitidine. Conclusion: Targeted 
      therapy combined with a HMA shows the most promising results in this 
      difficult-to-treat population.
FAU - Heuser, Michael
AU  - Heuser M
AUID- ORCID: 0000-0001-5318-9044
AD  - Department of Hematology, Hemostasis, Oncology & Stem Cell Transplantation, 
      Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
FAU - Fernandez, Cedric
AU  - Fernandez C
AUID- ORCID: 0000-0002-1559-2366
AD  - Servier International, 92284, Suresnes, France.
FAU - Hauch, Ole
AU  - Hauch O
AUID- ORCID: 0000-0002-0026-8301
AD  - Hauch Consultancy, 1060, Brussels, Belgium.
FAU - Klibanov, Olga M
AU  - Klibanov OM
AUID- ORCID: 0000-0002-0191-8265
AD  - IQVIA, Medical and Patient Communications, Parsippany, NJ 07054, USA.
FAU - Chaudhary, Tanushree
AU  - Chaudhary T
AUID- ORCID: 0000-0001-5147-3922
AD  - IQVIA, Real World Evidence, Gurugram, Haryana 12002, India.
FAU - Rives, Vincent
AU  - Rives V
AUID- ORCID: 0000-0002-7546-0007
AD  - Servier International, 92284, Suresnes, France.
LA  - eng
GR  - Servier International/
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20230512
PL  - England
TA  - Future Oncol
JT  - Future oncology (London, England)
JID - 101256629
RN  - 04079A1RDZ (Cytarabine)
RN  - M801H13NRU (Azacitidine)
SB  - IM
MH  - Humans
MH  - *Cytarabine
MH  - *Leukemia, Myeloid, Acute
MH  - Azacitidine/adverse effects
MH  - Combined Modality Therapy
MH  - Progression-Free Survival
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects
MH  - Induction Chemotherapy
OAB - Acute myeloid leukemia (AML) is a type of cancer of the bone marrow and blood 
      that leads to overproduction of immature white blood cells. High-dose (intensive) 
      chemotherapy is usually the first treatment option for AML. However, more than 
      half of people newly diagnosed with AML cannot receive the recommended initial 
      intensive chemotherapy due to older age or poor health. Treatment with low-dose 
      cytarabine (LDAC) and hypomethylating agents (HMAs), such as azacitidine, is key 
      for such people. We reviewed 26 clinical trials looking into available and 
      developing treatment options for people who cannot have the recommended initial 
      chemotherapy. The review found evidence that combining LDAC or HMA with a 
      targeted therapy can improve survival. In AML, new therapies (such as ivosidenib, 
      venetoclax and glasdegib) 'target' specific changes in the genes of cancer cells 
      to slow or stop their division and growth. The greatest improvement in survival 
      was seen in clinical trials where targeted therapies were added to azacitidine or 
      LDAC. Targeted therapies may result in certain side effects that require regular 
      monitoring. To provide patients with the benefits of targeted therapies they need 
      to undergo genetic testing at the time of diagnosis. Tests to determine an 
      individual's specific gene changes allows clinicians to develop personalised 
      treatment plans with available targeted therapies. This shows promise in 
      improving survival for people with AML who cannot receive initial intensive 
      chemotherapy.
OABL- eng
OTO - NOTNLM
OT  - IDH1
OT  - acute myeloid leukemia
OT  - hypomethylating agents
OT  - immunotherapy
OT  - ivosidenib
OT  - low-dose cytarabine
OT  - non-intensive chemotherapy
OT  - systematic literature review
OT  - targeted therapy
OT  - venetoclax
EDAT- 2023/05/12 13:08
MHDA- 2023/06/02 06:42
CRDT- 2023/05/12 06:13
PHST- 2023/06/02 06:42 [medline]
PHST- 2023/05/12 13:08 [pubmed]
PHST- 2023/05/12 06:13 [entrez]
AID - 10.2217/fon-2022-1286 [doi]
PST - ppublish
SO  - Future Oncol. 2023 Apr;19(11):789-810. doi: 10.2217/fon-2022-1286. Epub 2023 May 
      12.