Decitabine, a new drug undergoing Phase III efficacy trials, provides palliative therapy for patients with the bone marrow disease called Myelodysplastic Syndrome (MDS), according to a new study.
Published in the April 15, 2006 issue of CANCER, a peer-reviewed journal of the American Cancer Society, the study indicates that decitabine provided longer disease-free responses compared to supportive care. While the development of decitabine and other chemotherapies is making an impact on the lives of patients with MDS, an accompanying editorial argues that these current treatments are palliative at best and will have little additional improvement in survival.
MDS is a bone marrow disease of the elderly and one of the common geriatric blood-related cancers. It causes an increasing number of dysfunctional blood cells called blasts to proliferate in the blood at the expense of normal, functional cells - i.e., red blood cells to carry oxygen; white blood cells to fight infections; and platelets to control bleeding. MDS can be a chronic progressive disease with median survival over 5 years or a rapidly progressive disease complicated by acute myeloid leukemia (AML) with survival less than 5 years.
However, because most MDS patients are elderly and have too many risk factors to undergo a bone marrow transplant, therapy is often supportive. Chemotherapy regimens used for leukemia have been used, but results are disappointing and suggest great risk to patient lives than benefit. New drugs, such as 5--azacytidine, lenalidomide, decitabine, and cytarabine, are now being tested for efficacy and safety to treat MDS. Compared to supportive care, they generally have some quality of life and survival benefits.