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Impact of molecular mutations on treatment response to DNMT inhibitors in myelodysplasia and related neoplasms
Abstract
We hypothesized that specific molecular mutations are important biomarkers for response to DNA methyltransferase inhibitors (DNMT inhibitors) and may have prognostic value in patients with myelodysplastic syndromes (MDS). Mutational analysis was performed in 92 patients with MDS and related disorders who received 5-azacytidine (n=55), decitabine (n=26) or both (n=11). Mutational status was correlated with overall response rate (ORR), progression-free survival (PFS) and overall survival (OS) by univariate and multivariate analysis. Risk stratification models were created. TET2, DNMT3A, IDH1/IDH2, ASXL1, CBL, RAS and SF3B1 mutations were found in 18, 9, 8, 26, 3, 2 and 13% of patients, respectively. In multivariate analysis, TET2(MUT) and/or DNMT3A(MUT) (P=0.03), platelets > or = 100 × 10(9)/l (P=0.007) and WBC or = 10 g/dl (P=0.01). Better OS was associated with ASXL1(WT) (P=0.008) and SF3B1(MUT) (P=0.01), and, similar to PFS, cytogenetic risk (P=0.0002), age (P=0.02) and hemoglobin (P=0.04). These data support the role of molecular mutations as predictive biomarkers for response and survival in MDS patients treated with DNMT inhibitors.
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“A few studies using this approach have shown positive outcomes in patients with AML and patients with MDS with DNMT3A mutations, although the mechanisms are poorly understood (46–48).”
From Loss of Dnmt3a impairs hematopoietic homeostasis and myeloid cell skewing via the PI3Kinase pathway (2023) · cites this paper as [47]
Citations
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Clonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes
Steensma, D. P., Bejar, R., Jaiswal, S., Lindsley, R. C., Sekeres, M. A., Hasserjian, R. P., & Ebert, B. L. (2015) · Blood · doi:10.1182/blood-2015-03-631747 · Cited by 1,971
Self-citationShih, A. H., Jiang, Y., Meydan, C., Shank, K., Pandey, S., Barreyro, L., Antony-Debre, I., Viale, A., Socci, N., Sun, Y., et al. (2015) · Cancer Cell · doi:10.1016/j.ccell.2015.03.009 · Cited by 236
“Clinical studies indicate increased sensitivity to hypomethylating agents in TET2 mutant patients (Bejar et al., 2014; Traina et al., 2014), which may reflect an ability to reverse the effects of TET2 mutations on DNA methylation by these agents.”
BackgroundSekeres, M. A., Othus, M., List, A. F., Odenike, O., Stone, R. M., Gore, S. D., Litzow, M. R., Buckstein, R., Fang, M., Roulston, D., et al. (2017) · Journal of Clinical Oncology · doi:10.1200/jco.2015.66.2510 · Cited by 237
Self-citationCheng, J. X., Chen, L., Li, Y., Cloe, A., Yue, M., Wei, J., Watanabe, K. A., Shammo, J. M., Anastasi, J., Shen, Q. J., et al. (2018) · Nature Communications · doi:10.1038/s41467-018-03513-4 · Cited by 204
Craddock, C. F., Houlton, A. E., Quek, L. S., Ferguson, P., Gbandi, E., Roberts, C., Metzner, M., Garcia-Martin, N., Kennedy, A., Hamblin, A., et al. (2017) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-17-1423 · Cited by 88
Digging deep into “dirty” drugs – modulation of the methylation machinery
Pleyer, L., & Greil, R. (2015) · Drug Metabolism Reviews · doi:10.3109/03602532.2014.995379 · Cited by 84
“However, the presence of mutated TET2 has been associated with response to AZA and DAC in MDS and CMML by several (Braun et al., 2011; Itzykson et al., 2011; Traina et al., 2014; Voso et al., 2011), but not all groups (Pollyea et al., 2011).”
BackgroundHunter, A. M., Komrokji, R. S., Yun, S., Al Ali, N., Chan, O., Song, J., Hussaini, M., Talati, C., Sweet, K. L., Lancet, J. E., et al. (2021) · Blood Advances · doi:10.1182/bloodadvances.2020003508 · Cited by 76
Singhal, D., Wee, L. Y. A., Kutyna, M. M., Chhetri, R., Geoghegan, J., Schreiber, A. W., Feng, J., Wang, P. P.-S., Babic, M., Parker, W. T., et al. (2019) · Leukemia · doi:10.1038/s41375-019-0479-8 · Cited by 62
Self-citationLoss of Dnmt3a impairs hematopoietic homeostasis and myeloid cell skewing via the PI3Kinase pathway
Palam, L. R., Ramdas, B., Pickerell, K., Pasupuleti, S. K., Kanumuri, R., Cesarano, A., Szymanski, M., Selman, B., Dave, U. P., Sandusky, G., et al. (2023) · JCI Insight · doi:10.1172/jci.insight.163864 · Cited by 13
Metadata
- Authors
- Traina, F., Visconte, V, Elson, P., Tabarroki, A., Jankowska, A. M., Hasrouni, E., Sugimoto, Y., Szpurka, H., Makishima, H., O'Keefe, C. L., Sekeres, M. A., Advani, A. S., Kalaycio, M., Copelan, E. A., Saunthararajah, Y., Olalla Saad, S. T., Maciejewski, J. P., & Tiu, R. V.
- Venue
- Leukemia
- Published
- 2013-09-18
- Volume
- 28
- Issue
- 1
- Pages
- 78-87
- ISSN
- 0887-6924
- 1476-5551
- Cited by
- 269
- References
- 8
- Language
- en
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