Treatment-Free Remission and Dasatinib Discontinuation for Chronic Phase CML
Posted: Monday, November 25, 2019
According to Neil P. Shah, MD, PhD, of the University of California, San Francisco School of Medicine, and colleagues, treatment-free remission appears to be a feasible goal for patients with chronic phase chronic myeloid leukemia (CML) after dasatinib discontinuation, especially because second-generation tyrosine kinase inhibitors may induce higher rates of sustained deep molecular remission. The DASFREE study, reported in Leukemia & Lymphoma, provided clinically relevant information on treatment-free remission, including appropriate treatment duration and duration of response criteria prior to treatment cessation, as well as newly identified prognostic factors.
The single-arm, multicenter, phase II trial assessed treatment-free remission after dasatinib discontinuation in 84 patients with chronic phase CML. Analyses were conducted after a minimum follow-up of 2 years.
The treatment-free remission rate after 2 years was 46%. Statistically significant associations were found between 2-year treatment-free remission and the duration of prior dasatinib treatment (≥ median duration; P = .0051), first-line therapy (P = .0138), and age (> 65 years; P = .0012).
No disease transformation events were reported. Dasatinib withdrawal events were observed in nine patients. The most common adverse events experienced off treatment were musculoskeletal, and they were reported in 30 patients, 11 of which were attributed to treatment withdrawal.
“These data support the practicality of treatment-free remission in patients with resistance to or intolerance of prior tyrosine kinase inhibitor treatment and, perhaps most importantly, confirm the feasibility and safety of dasatinib discontinuation in patients stopping first-line treatment,” the authors concluded.
Disclosure: For full disclosures of the study authors, visit tandfonline.com.