Differential response to hypomethylating agents based on sex: a report on behalf of the MDS Clinical Research Consortium (MDS CRC)

被引:17
|
作者
DeZern, Amy E. [1 ]
Zeidan, Amer M. [2 ]
Barnard, John [3 ]
Hand, Wesley [1 ]
Al Ali, Najla [4 ]
Brown, Francis [5 ]
Zimmerman, Cassie [3 ]
Roboz, Gail J. [6 ]
Garcia-Manero, Guillermo [7 ]
Steensma, David P. [5 ]
Komrokji, Rami S. [4 ]
Sekeres, Mikkael A. [3 ]
机构
[1] Sidney Kimmel Canc Ctr, Dept Oncol, Philadelphia, PA 19107 USA
[2] Yale Univ, Yale Canc Ctr, New Haven, CT 06520 USA
[3] Cleveland Clin Taussig Canc Inst, Leukemia Program, Cleveland, OH USA
[4] Hematol Malignancies H Lee Moffitt Canc Ctr, Tampa, FL USA
[5] Dana Farber Canc Inst, Dept Med Oncol, Adult Leukemia Program, Boston, MA USA
[6] Cornell Univ, Weill Med Coll, Leukemia Program, New York, NY USA
[7] MD Anderson Comprehens Canc Ctr, Houston, TX USA
关键词
Sex; hypomethylating agents; MDS; azacitidine; decitabine; RISK MYELODYSPLASTIC SYNDROME; CYTIDINE DEAMINASE; SCORING SYSTEM; DECITABINE; 3,4,5,6-TETRAHYDROURIDINE; PHARMACOKINETICS; BIOAVAILABILITY; 5-AZACYTIDINE; AZACITIDINE; INHIBITION;
D O I
10.1080/10428194.2016.1246726
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
First-line therapy for higher-risk myelodysplastic syndromes (MDS) includes decitabine (DAC) or azacitidine (AZA). Variables have not identified differential response rates between these. We assessed the influence of patient sex on outcomes including overall survival (OS) in 642 patients with higher-risk MDS treated with AZA or DAC. DAC-treated patients (35% of females, 31% of males) had marginally better OS than AZA-treated patients (p=.043), (median OS of 18.7 months versus 16.4 months), but the difference varied strongly by sex. Female patients treated with DAC had a longer median OS (21.1 months, 95% CI: 16.0-28.0) than female patients treated with AZA (13.2 months, 95% CI: 11.0-15.9; p=.0014), while for males there was no significant difference between HMAs (median OS 18.3 months with DAC versus 17.9 months for AZA, p=.59). The biological reason for this variability is unclear, but may be a consequence of differences in cytidine deaminase activity between men and women.
引用
收藏
页码:1325 / 1331
页数:7
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