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Relevance of treatment-free remission recommendations in chronic phase chronic leukemia patients treated with frontline tyrosine kinase inhibitors.
- Source :
-
Cancer medicine [Cancer Med] 2021 Jun; Vol. 10 (11), pp. 3635-3645. Date of Electronic Publication: 2021 May 14. - Publication Year :
- 2021
-
Abstract
- Background: Tyrosine kinase inhibitors (TKI) can be safely discontinued in chronic phase chronic myeloid leukemia (CP-CML) patients who had achieved a sustained deep molecular response. Based on the results of discontinuation trials, recommendations regarding patient selection for a treatment-free remission (TFR) attempt had been proposed. The aims of this study were to evaluate the rate of patients eligible for TKI discontinuation and molecular recurrence-free survival (MRFS) after stop according to recommendations.<br />Methods: Over a 10-year period, newly diagnosed CP-CML patients and treated with first-line TKI in the nine French participating centers were included. Eligibility to treatment discontinuation and MRFS were analyzed and compared according to selection criteria defined by recommendations and first-line treatments.<br />Results: From January 2006 to December 2015, 398 patients were considered. Among them, 73% and 27% of patients received imatinib or either second or third generation tyrosine kinase inhibitors as frontline treatment, respectively. Considering the selection criteria defined by recommendations, up to 55% of the patients were selected as optimal candidates for treatment discontinuation. Overall 95/398 (24%) discontinued treatment. MRFS was 51.8% [95% CI 41.41-62.19] at 2 years and 43.8% [31.45-56.15] at 5 years. Patients receiving frontline second-generation TKI and fulfilling the eligibility criteria suggested by recommendations had the lowest probability of molecular relapse after TKI stop when compare to others.<br />Conclusion: One third of CP-CML patients treated with TKI frontline fulfilled the selection criteria suggested by European LeukemiaNet TFR recommendations. Meeting selection criteria and second-generation TKI frontline were associated with the highest MRFS.<br /> (© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Female
France
Fusion Proteins, bcr-abl analysis
Guidelines as Topic
Humans
Leukemia, Myeloid, Chronic-Phase genetics
Male
Middle Aged
Progression-Free Survival
Recurrence
Remission Induction
Young Adult
Imatinib Mesylate therapeutic use
Leukemia, Myeloid, Chronic-Phase drug therapy
Patient Selection
Protein Kinase Inhibitors therapeutic use
Withholding Treatment statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 2045-7634
- Volume :
- 10
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Cancer medicine
- Publication Type :
- Academic Journal
- Accession number :
- 33988316
- Full Text :
- https://doi.org/10.1002/cam4.3921