The workforce is led by researchers from SWOG Cancer Research Network, a most cancers medical trials group funded by the National Cancer Institute (NCI), a part of the National Institutes of Health (NIH), working with investigators from the UK Medical Research Council/National Cancer Research Institute (MRC/NCRI).
“To our knowledge, this is the first attempt to build tools to predict outcomes for patients receiving non-intensive AML therapy to inform decision-making and, ultimately, improve treatment outcomes,” stated senior writer Megan Othus, PhD, a SWOG biostatistician primarily based on the Fred Hutchinson Cancer Research Center.
Adults identified with acute myeloid leukemia are sometimes handled with intensive chemotherapy, and several other statistical fashions have been developed to foretell whether or not a affected person is prone to profit from this remedy.
But some sufferers with AML, notably sufferers age 75 and older and people with different sicknesses, might not tolerate the unintended effects of intensive chemotherapy and are due to this fact handled with various much less intensive therapies. At this time, no instruments exist that may precisely predict which sufferers are prone to profit most from these non-intensive therapies.
To handle this lack, the researchers developed and examined a number of statistical fashions that predicted the danger of early demise for AML sufferers on non-intensive therapies. They initially constructed the fashions utilizing information from the LI-1 medical trial of 796 sufferers (median age 75), which was performed by the MRC/NCRI. The workforce then validated the accuracy of their fashions towards information from one other 540 sufferers (median age 77) who had enrolled in three leukemia medical trials performed by the SWOG Cancer Research Network – S0432, S0703, and S1612.
The fashions use a affected person’s age and quite a lot of measures of the affected person’s well being, equivalent to efficiency standing (a measure of how nicely the affected person can carry out atypical duties), white blood cell and platelet counts, the presence or absence of a selected genetic mutation (NPM1), and several other self-reported measures of the affected person’s high quality of life.
The group discovered that, though all their fashions had been solely modestly profitable in predicting early demise in each the MRC/NCRI trial sufferers and the SWOG trial sufferers, the best fashions had been those who included a number of quality-of-life scores from a extensively used patient-reported final result survey referred to as the QLQ-C30 instrument.
The researchers say their outcomes spotlight the difficulties in predicting outcomes for these sufferers utilizing solely routinely out there medical info.
“Making predictive models that are more accurate and useful,” Othus stated, “may require incorporating information from additional blood and toxicity biomarkers collected in the early stages of a patient’s treatment or information from additional patient-reported outcome measures.”