Honors & Awards


  • Young Investigator Award, ASCO (2014)
  • KL2 Fellowship, Spectrum (2014-2016)

Current Research and Scholarly Interests


My primary research interest is in improving outcomes in acute myeloid leukemia (AML). From a clinical trial standpoint, I am interested in combining novel small molecule inhibitors with conventional chemotherapy. From a population-based standpoint, I am conducting a retrospective analysis of outcomes in AML patients at Stanford who have undergone hematopoietic cell transplantation, as well as a collaborative project with the Cancer Prevention Institute of California analyzing outcomes in AML patients with data from the Surveillance and Epidemiology End Results (SEER).

All Publications


  • Sequential azacitidine plus lenalidomide in previously treated elderly patients with acute myeloid leukemia and higher risk myelodysplastic syndrome. Leukemia & lymphoma Narayan, R., Garcia, J. S., Percival, M. M., Berube, C., Coutre, S., Gotlib, J., Greenberg, P., Liedtke, M., Hewitt, R., Regan, K., Williamson, C., Doykan, C., Cardone, M. H., McMillan, A., Medeiros, B. C. 2016; 57 (3): 609-615

    Abstract

    The outcome of sequential azacitidine with lenalidomide has not been reported in previously treated patients with acute myeloid leukemia (AML) and higher risk myelodysplastic syndrome (MDS). We describe a phase 2 study evaluating the safety and efficacy of this combination in elderly patients with AML and MDS with prior hypomethylating agent (HMA) and/or immunomodulatory agent exposure. Patients were treated on a 42-day cycle with azacitidine at 75 mg/m2 SQ/IV daily on days 1-7, followed by lenalidomide 50 mg orally daily on days 8-28. Median number of treatment cycles on study was two (range, 1-11). Of 32 evaluable patients, the overall response rate was 25%. Neutropenic fever was the most common serious adverse event, but overall the combination was well-tolerated. The median overall survival (OS) for responders versus non-responders was 9.8 versus 4.0 months, respectively (HR 0.36, p=0.016). In conclusion, this combination demonstrated modest clinical activity in this poor risk population.

    View details for DOI 10.3109/10428194.2015.1091930

    View details for PubMedID 26374199

  • Improvements in the early death rate among 9380 patients with acute myeloid leukemia after initial therapy: A SEER database analysis CANCER Percival, M. M., Tao, L., Medeiros, B. C., Clarke, C. A. 2015; 121 (12): 2004-2012

    Abstract

    Acute myeloid leukemia (AML) is treated with conventional induction chemotherapy shortly after diagnosis for the majority of patients aged ≤65 years. A recent report suggested a substantial decline in the early, or 1-month, mortality rate in patients treated on clinical trials over the past 2 decades. It is unknown whether a similar improvement has been observed in the general population.The authors examined the 1-month mortality rate in a large population-based series of 9380 patients with AML who were aged ≤65 years and were diagnosed and treated with chemotherapy between 1973 and 2010.A significant decline was observed in the 1-month mortality rate from 18.7% among patients diagnosed from 1973 through 1977 (95% confidence interval [95% CI], 16.4%-21.2%) to 5.8% for those diagnosed between 2008 and 2010 (95% CI, 4.5%-7.6%) (P <.001). The median overall survival improved significantly from 6 months (95% CI, 5 months-7 months) in 1973 to 1977 to 23 months (95% CI, 16 months-20 months) in 2008 to 2010 (P <.001). Although age and geographic variation were found to significantly influence the 1-month mortality for the period between 1973 and 1977, these differences in 1-month mortality were no longer significant among patients with AML who were treated more recently (2008-2010).Over the past 4 decades, early mortality has become uncommon in younger patients (aged ≤65 years) with newly diagnosed AML undergoing induction chemotherapy. It is encouraging that the improvements noted in 1-month mortality rate among a selective cohort of patients in clinical trials have also been observed in a population-based analysis. Cancer 2015. © 2015 American Cancer Society.

    View details for DOI 10.1002/cncr.29319

    View details for Web of Science ID 000355768300015