title: More is better: combination therapies for myelodysplastic syndromes.
abstract: The myelodysplastic syndromes (MDS) are a heterogenous collection of clonal hematopoietic malignancies that exist as a subgroup of the myeloid neoplasms as classified by the World Health Organization (WHO). They are characterized by ineffective hematopoiesis, subsequent cytopenias, transformation to acute myeloid leukemia (AML), and poor overall survival. There are currently three FDA-approved medications for MDS; lenalidomide, azacitidine, and decitabine. The role of these agents is to diminish the clinical impact of MDS and delay its progression to AML. However, despite known results with these monotherapies, recent clinical trials with a variety of combinations for MDS have demonstrated promising results. These trials include combinations of hypomethylating agents, histone deacetylase inhibitors, growth factors, and chemotherapy among others. In this paper we review the current literature on combination therapies in MDS, analyze on-going and concluded trials, and suggest future possibilities for combination strategies in MDS.
authors: Leukemia Program, Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, 9500 Euclid Avenue, NA10, Cleveland, OH 44195, USA. Electronic address: ornstem@ccf.org.
authors: Moshe C
authors: MC
authors: Ornstein
authors: Leukemia Program, Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, 9500 Euclid Avenue, NA10, Cleveland, OH 44195, USA. Electronic address: mukhers2@ccf.org.
authors: Sudipto
authors: S
authors: Mukherjee
authors: Leukemia Program, Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, 9500 Euclid Avenue, NA10, Cleveland, OH 44195, USA. Electronic address: sekerem@ccf.org.
authors: Mikkael A
authors: MA
authors: Sekeres
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001374:Azacitidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D001549:Benzamides / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D000077209:Decitabine; D018450:Disease Progression; D004359:Drug Therapy, Combination; D015870:Gene Expression / Q000187:drug effects; D056572:Histone Deacetylase Inhibitors / Q000627:therapeutic use*; D006655:Histone Deacetylases / Q000235:genetics* / Q000378:metabolism; D006801:Humans; D006877:Hydroxamic Acids / Q000627:therapeutic use; D000077269:Lenalidomide; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D011743:Pyrimidines / Q000627:therapeutic use; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use; D000077337:Vorinostat
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D056572:Histone Deacetylase Inhibitors; D006877:Hydroxamic Acids; D011743:Pyrimidines; D013792:Thalidomide; D000077337:Vorinostat; D014635:Valproic Acid; D000077209:Decitabine; C523184:mocetinostat; D006655:Histone Deacetylases; D000077269:Lenalidomide; D001374:Azacitidine
keywords: MDS; azacitidine; combination; decitabine; lenalidomide; mocetinostat; valproic acid; vorinostat