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Old Fri Apr 23, 2010, 01:28 PM
Birgitta-A Birgitta-A is offline
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Join Date: Oct 2007
Location: Stockholm, Sweden
Posts: 1,918
Dacogen

Hi Neil,
The most important of your questions is "Which lower risk MDS patients should receive Dacogen?" Actually we don't know which high risk patients that will respond either.

The truth is that we don't know much about administration of treatment with Dacogen or Vidaza. In PubMed there are 173 reports about Dacogen in MDS patients (some of them are really AML patients).

Then clin trials gov reports about 39 trials with Dacogen in MDS – about 16 of them are recruiting patients. In most of these trials Dacogen is combined with other drugs for better effect.

Since Dacogen is a hypomethylating drug the researcher try to study the patients DNA methylation levels. They found that patients with higher levels of methylation, compared with patients with lower levels, had a shorter median overall survival and shorter median progression-free survival but methylation at baseline did not correlate with clinical response to decitabine.
http://www.ncbi.nlm.nih.gov/pubmed/20038729

So today we still don’t know which MDS patient should receive the drug but we can hope that they will find other important differences between responders and nonresponders. Remember how the drug Gleevec (and now still more effective drugs) has changed the future for patients with CML.
Kind regards
Birgitta-A
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