Evidence map›Paper›PMID 39367118›Full record

Trial reportAnnals of hematology2025

Midostaurin added to 10-day decitabine, for patients unfit for intensive chemotherapy with AML and higher risk MDS, irrespective of FLT3 mutational status, does not improve outcome.

Gerwin Huls, Dana A Chitu, Lidwine Tick, Rinske Boersma, Dimitri Breems, Alexandra Herbers, Saskia K Klein, Suzan de Jonge, Peter E Westerweel, Marjan Cruijsen and 14 more

Abstract readMulticenter StudyRandomized Controlled TrialClinical Trial, Phase II
In one paragraph

Trial report in Annals of hematology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Gerwin HulsDepartment of Hematology, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands. g.huls@umcg.nl.
Dana A ChituDepartment of Hematology, Hemato Oncology Foundation for Adults in the Netherlands, Rotterdam, The Netherlands.
Lidwine TickDepartment of Hematology, Maxima Medical Center, Veldhoven, The Netherlands.
Rinske BoersmaDepartment of Hematology, Amphia Hospital, Breda, The Netherlands.
Dimitri BreemsDepartment of Hematology, ZNA Stuivenberg/Middelheim, Antwerp, Belgium.
Alexandra HerbersDepartment of Hematology, Jeroen Bosch Hospital, Den Bosch, The Netherlands.
Saskia K KleinDepartment of Hematology, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands.
Suzan de JongeDepartment of Hematology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
Peter E WesterweelDepartment of Hematology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
Marjan CruijsenDepartment of Hematology, Catharine Hospital, Eindhoven, The Netherlands.
Mels HoogendoornDepartment of Hematology, Medical Center Leeuwarden, Leeuwarden, The Netherlands.
Marlous CuijpersDepartment of Hematology, Rijnstate Hospital, Arnhem, The Netherlands.
Dries DeerenDepartment of Hematology, AZ Delta Roeselare, Roeselare, Belgium.
Benjamin BaillyDepartment of Hematology, Hopital de Jolimont, Haine-Saint-Paul, Belgium.
Otto VisserDepartment of Hematology, Isala Hospital, Zwolle, The Netherlands.
Anna van RhenenDepartment of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands.
Eduard F M PosthumaDepartment of Hematology, Reinier de Graaf Hospital, Delft, The Netherlands.
Peter J M ValkDepartment of Hematology, Erasmus MC Cancer Center, Erasmus University Medical Center, Rotterdam, The Netherlands.
Jacqueline CloosDepartment of Hematology, Amsterdam UMC, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands.
Emanuele AmmatunaDepartment of Hematology, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands.
Jeannine M RefosDepartment of Hematology, Hemato Oncology Foundation for Adults in the Netherlands, Rotterdam, The Netherlands.
R FakkertDepartment of Hematology, Hemato Oncology Foundation for Adults in the Netherlands, Rotterdam, The Netherlands.
Bob LöwenbergDepartment of Hematology, Erasmus MC Cancer Center, Erasmus University Medical Center, Rotterdam, The Netherlands.
Gert J OssenkoppeleDepartment of Hematology, Amsterdam UMC, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The treatment of older patients with acute myeloid leukemia (AML) considered unfit for receiving intensive chemotherapy is challenging. Based on the hypothesis that addition of the broad tyrosine kinase inhibitor (TKI) midostaurin could improve the response to hypomethylating agents, irrespective of FLT3 gene mutational status, we conducted a randomized phase II multicenter study to assess the tolerability and efficacy of the addition of midostaurin to a 10-day schedule of decitabine in unfit (i.e. Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI) ≥ 3) AML and higher risk myelodysplasia (MDS) patients (HOVON155 trial). In total, 140 eligible patients were randomly (1:1) assigned to treatment with 10-days of decitabine alone (N = 70) or combined with midostaurin (50 mg bid;starting the day following the last dose of decitabine), (N = 70). Addition of midostaurin was well tolerated and the number of AEs was comparable for both treatment arms. Early death rates (< 30 days) were similar as well (10%). In the decitabine plus midostaurin arm 24% reached CR/CRi, the median OS was 4.8 months and 1-yrs OS was 31% which compared with 34% CR/CRi, median OS of 7.4 months and 1-yrs OS of 37% for the decitabine alone group (NS). Thus, while the addition of midostaurin appears safe, it does not enhance therapeutic efficacy of decitabine in unfit AML patients.

Indexed as

Antineoplastic Combined Chemotherapy Protocolsfms-Like Tyrosine Kinase 3Leukemia, Myeloid, AcuteMutationMyelodysplastic SyndromesStaurosporineAdultAgedAged, 80 and overAzacitidineDecitabineFemaleHumansMaleMiddle AgedTreatment OutcomeAzacitidineDecitabineFLT3 protein, humanfms-Like Tyrosine Kinase 3midostaurinStaurosporineAMLDecitabineMidostaurinOlderPhase II trial

Identifiers

PMID39367118
PMCPMC11868317

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.