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Chronic Phase CML Outcomes Update in the Era of Multiple TKIs

By: Joseph Fanelli
Posted: Tuesday, July 28, 2020

According to findings from a retrospective study presented in the Journal of Clinical Medicine, patients with chronic phase chronic myeloid leukemia (CML) who responded to one tyrosine kinase inhibitor (TKI) demonstrated better 10-year overall survival than patients treated with between two and five TKIs. In fact, 100% of patients treated with a single TKI were alive at 10 years, compared with 55% of those treated with five TKIs. However, Vamsi K. Kota, MD, of the Georgia Cancer Center at Augusta University, and colleagues noted that multiple TKIs did enable more patients to achieve treatment-free remission.

“Early molecular response at 3 and 6 months and the Hasford or EUTOS risk scores were still valuable in predicting overall survival,” the authors concluded.

The authors reviewed the records of patients with chronic phase CML who were treated with TKIs at the Georgia Cancer Center. From 2005 to 2016, 206 patients were followed for a median of 48.8 months. Of the patients, 76 (37%) received one TKI, 73 (35%) received two TKIs, and 57 (28%) received more than 3 TKIs.

Of the study patients, 19 (9.2%) progressed to advanced phase CML, and 69 achieved complete molecular response with first-line treatment. In addition, 55 patients reached a complete molecular response after second-line treatment, whereas 25 patients (12.1%) attempted to discontinue TKIs therapy and 14 (6.8%) stopped treatment with TKIs for a median of 6.3 months.

For all patients, the 10-year progression-free survival rate was 81%, and the overall survival rate was 87%. After 10 years, the overall survival rates were 100% with one TKI, 82% with two TKIs, 87% with three TKIs, 75% with four TKIs, and 55% with five TKIs.

Disclosure: The authors reported no conflicts of interest.



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