Concise drug review: Azacitidine and decitabine

摘要

The hypomethylating agents azacitidine and decitabine (5-aza-2'-deoxycytidine) are currently approved for the treatment of several specific forms of myelodysplastic syndromes (MDS), chronic myelomonocytic leukemia (CMML), and acute myeloid leukemia (AML), as depicted in Table 1.The only potentially curative therapy for patients with higher-risk MDS (International Prognostic Scoring System intermedi-ate-2 risk and high risk) is an allogeneic stem cell transplantation (allo-SCT). However, for the majority of patients, allo-SCT is not an option because of advanced age and/or comorbidities. In addition, the results obtained with intensive chemotherapy (when feasible) are often disappointing. For patients with MDS, the probability of complete remission after intensive chemotherapy is generally lower and the remission duration shorterthan for patients with primary AML [1]. Therefore, the introduction of the hypomethylating agents has been a major advancement in the treatment of patients with higher-risk M DS who are ineligible for allo-SCT. Table 2 summarizes the key pharmacologic features of these two agents.