Different Azacitidine Administration Schedules Lead to Similar Outcomes in MDS

HOUSTON — There was no significant difference in outcomes between patients with myelodysplastic syndromes (MDS) who were treated with azacitidine on a five-day schedule or a five-plus-two-day schedule, according to a recent study.

Guilherme Sapinho MD, MSc, of the Centro Hospitalar Universitário Lisboa Nortea and the Universidade de Lisboa in Portugal and colleagues conducted the study and presented their findings at the 10th Annual Meeting of the Society of Hematologic Oncology.

Dr. Sapinho and colleagues performed the research because the full azacitidine schedule of 75 mg/m² daily for seven consecutive days leads to a “logistic challenge for outpatient weekend administration,” they wrote. While the use of five-day and five-plus-two-day schedules has been studied to address this issue, “the quality of the evidence is low; most studies were performed in low-risk populations and with total dose reduction in five-day schedules,” Dr. Sapinho and colleagues wrote.

The single-center, retrospective cohort study compared the impacts of a five-day full-dose azacitidine treatment schedule and a five-plus-two-day full-dose schedule in patients with high-risk MDS. Researchers evaluated 100 patients for overall survival (OS) and evaluated a subsample of 49 patients for secondary outcomes including acute myeloid leukemia (AML)-free survival, probability of infections, and transfusion burden.

There was no significant difference in the median OS between patients treated with a five-day schedule (12.5 months) and those treated with a five-plus-two-day schedule (15 months; log-rank P=.97; hazard ratio [HR], 0.95; 95% CI, 0.57-1.56). There was also no significant difference in the AML-free survival between patients treated with the five-day schedule compared with those treated with the five-plus-two-day schedule (log-rank P=.22; HR, 1.70; 95% CI, 0.70-4.14). In a multivariate analysis, the treatment schedules were not predictive of infections, nor the number of red blood cell or platelet transfusions.

“Full-dose azacitidine can be administered both in five days and seven days with a weekend break with no significant difference in survival, infection, or transfusional outcomes,” Dr. Sapinho and colleagues concluded.

Reference

Sapinho G, Alves-Ribeiro L, Infante J. Impact of two azacitidine administration schedules in myelodysplastic syndromes. Abstract MDS-308. Presented at the 10th Annual Meeting of the Society of Hematologic Oncology, September 28-October 1, 2022.