Subsequent attempt tyrosine kinase inhibitor discontinuation in patients with chronic myeloid leukemia; a single institute experience.

Hematological Oncology
Hiroshi UreshinoShinya Kimura

Abstract

Discontinuation of tyrosine kinase inhibitors (TKIs) is now a feasible therapeutic goal for patients with chronic phase chronic myeloid leukemia (CML-CP). Whereas approximately half of patients experience molecular relapse, after resuming with any TKI; the majority re-achieve a deep molecular response (DMR). It is unclear whether such patients who re-achieve a durable DMR can discontinue TKI safely again. Here, we retrospectively assessed first, second, and third attempts to stop TKIs in patients with CML-CP. At the first attempt, 28 out of a total of 53 patients achieved sustained treatment-free remission (TFR; 53.4%; 95% confidence interval [CI], 39.0%-65.9%). Subsequently, 10 of 25 patients attempted a second TKI discontinuation, and in all cases, this was after receiving second-generation TKIs. Four of 10 patients successfully achieved TFR (37.5%; 95% CI, 9.9%-65.9%). All patients who relapsed at the second TKI discontinuation attempt were re-administered TKIs, and soon achieved at least a major molecular remission. All six second relapse patients had a loss of MR4.5 at 3 months after TKI discontinuation. These findings suggest that second and third attempts to successfully stop TKI treatment are feasible in patients with C...Continue Reading

References

Oct 12, 2011·International Journal of Clinical Oncology·Chikashi YoshidaHisashi Sakamaki
Mar 9, 2017·The New England Journal of Medicine·Andreas HochhausUNKNOWN IRIS Investigators
Jul 26, 2017·Cancer·Laurence LegrosUNKNOWN French Intergroup for Chronic Myeloid Leukemias
Apr 27, 2018·Cancer Immunology Research·Hiroshi UreshinoShinya Kimura
Jul 12, 2019·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Franck Emmanuel NicoliniFrançois-Xavier Mahon
Feb 28, 2020·Nature·Ajithkumar VasanthakumarAxel Kallies
Jul 1, 2017·Annals of Oncology : Official Journal of the European Society for Medical Oncology·A HochhausUNKNOWN ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org
Aug 10, 2020·Clinical Lymphoma, Myeloma & Leukemia·Hiroshi UreshinoShinya Kimura

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