The creation of SIOG, and a systematic review of the AML literature

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Published: 22 Nov 2016
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Dr Martine Extermann - Moffitt Cancer Center, Tampa, USA

Dr Extermann speaks with ecancertv at SIOG 2016 about the creation of the SIOG society, and the challenges and successes of improving cancer care worldwide.

She also discusses her systematic review of the literature relating to AML and the evidence that we have for treating relapsed/refractory AML in patients 70 and older.

This service has been kindly supported by an unrestricted grant from Merck/MSD.

I had the pleasure of being one of the founding members of SIOG. We were a group of about a dozen persons, I remember we met in a room at the SIOG, it was not yet the SIOG conference, the aging conference in cancer in New York in 2000 and we decided to create the society. We started, we made a committee and it was very important for us to make this society. Initially we wanted it mainly to make the aging in cancer conferences that we were doing more permanent, more solid. As the society grew we started having a bolder agenda of being really the expert reference in geriatric oncology, tackling how we can improve the cancer care of these older patients all around the world and being the leading society and thinking through the agenda for that.

Could you talk about what you presented at SIOG this year?

I reported a portion of the results of a large grant we received from the NIH to do a very systematic review of the literature and understand better what evidence we have available to treat older patients with acute myelogenous leukaemia. Traditionally in haematology studies older patients are described as 60 and above and that dates back from the times where you wouldn’t do a transplant above the age of 60. Now you can do quite a few transplants between the age of 60 and 70 but it’s still very rare above the age of 70 so we wanted to look at this group of patients above the age of 70, can we help with the decision making for their treatment, can we gather the evidence? So part of the work is the frontline regimens but in this particular abstract we look at what is the evidence to treat these patients when they relapse.

So we went through an extensive literature search and we found that there was no study that focussed only on patients 70 and above so we decided let’s take the studies that have a subgroup of patients in the age of 70 and above. How do you find that in the literature? You look and you first look for the studies where the upper age limit of the patients in the studies is above the age of 70. We identified 64 studies that had that upper age limit above the age of 70. Of these 64 studies only three actually described the subgroup of patients above 70. They had very variable results so I cannot give a recipe about how to best treat patients above 70 but we certainly identified a need for more focussed evidence in these patients.

I would say in general the literature to treat relapsed acute myelogenous leukaemia is very heterogeneous so we should do more efforts as the systematic review at identifying the most promising drug combinations that can be formally compared with each other and with good cytogenetic stratification with modern stratifications of that in order to get solid evidence to treat these older AML patients.