Patterns of Care Survey for Myelodysplastic Syndromes (MDS)

EDITOR'S COMMENT: Our most recent Patterns of Care survey of 100 US-based medical oncologists in community practice revealed few surprises. In our last email program, we reviewed data related to management of AML, and in this issue we review questions on MDS.

I was fascinated by the divergence of perspectives on this complex disease. For example, for a 78-year-old man with intermediate IPSS MDS, 60 percent of oncologists would recommend 5-azacitidine, 14 percent chose decitabine, and 14 percent chose lenalidomide, but it could be that as in other types of cancer, a rational future goal might be to give patients a series of agents sequentially.

Duration of therapy may be another key issue to explore in other studies, but the survey found that in contrast to the landmark clinical trial demonstrating a survival advantage in which 5-azacitidine was continued indefinitely or until disease progression, 39 percent of our respondents generally planned on nine or fewer cycles of treatment.

One consistent observation in our CME activities is that there is a direct correlation between the frequency of specific types of cancer and the interest oncologists have in learning about new clinical research and investigator opinion. From that perspective our survey shows that MDS seems to be about as common in oncology practice as CLL and multiple myeloma, so we hope the pace of clinical research on this disease will continue to accelerate, and we will have additional important options and issues to evaluate in future surveys.