Decitabine, a recently developed drug, might help older patients with acute myeloid leukemia (AML), an international team of researchers claim.
The drug has been found to reactivate genes that cancer cells turn off. It could act as a first-line treatment for these patients, who have limited treatment options.
Advertisement"Older leukemia patients don't have good treatment options because the chemotherapy and stem cell transplants that we commonly use for younger patients are often too toxic for them," said lead author Amanda F. Cashen, M.D., assistant professor of medicine in the Division of Oncology and a bone marrow transplant specialist with the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.
"Furthermore, the biology of acute leukemia in the older patient population is different, making their response rate lower, their risk of relapse higher and their cure rates lower.
"So we definitely need new therapies in that patient population - treatments that are going to be both better tolerated and more effective," she added.
The researchers tested decitabine in 55 AML patients with an average age of 74 years.
During the study, all patients received the same decitabine dose for five consecutive days every four weeks until their disease stopped responding to the drug and began progressing or until an adverse event occurred to prevent further participation.
By comparison to standard chemotherapy and stem cell transplantation, the treatment was considered a low-intensity treatment and was more tolerable for elderly patients, especially those with accompanying medical problems.
In 24 percent of the study participants, blood counts and bone marrow returned to normal, which is considered a complete response.
In those with a complete response, average survival time was 14 months. For all study participants, average survival time was 7.7 months.
"We have to wait for the results of further trials of decitabine to have a better estimate of the response rate and survival outcome compared to other low intensity options for older adults," Cashen said.
"This study can't definitively establish decitabine's role for treating older adults with AML, but it certainly excites us to study it more," she added.
The study is published online in the Journal of Clinical Oncology.
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