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Is TKI Type Linked to Treatment-Free Remission in Patients With CML?

By: Joshua Swore
Posted: Friday, May 29, 2020

The tyrosine kinase inhibitor dasatinib did not significantly improve treatment-free remission in patients with chronic myeloid leukemia (CML) compared with other types of tyrosine kinase inhibitors (TKIs), according to a study published in the International Journal of Hematology. “The results of the present trial were also similar to those of TKI stop trials using second-generation TKIs and stop trials using imatinib as front-line treatment,” according to Hiroki Yamaguchi MD, PhD, of the Nippon Medical School, Tokyo, and colleagues. “This suggests that improving the [treatment-free remission] rate has little to do with the type of TKI.”

A total of 26 patients ranging from age 23 to 75 were included in the study analysis. Patients were treated with 100 to 140 mg of dasatinib daily until a deep molecular response was reached within a 2-year span. Then, patients continued dasatinib treatment while sustaining a deep molecular response for 2 years.

After dasatinib treatment, recurrence was observed in 16 patients, with a median recurrence-free survival of 5.1 months, and 38.5% of patients achieved a 12-month recurrence-free survival. A total of 14 patients restarted treatment after recurrence. Deep molecular response was achieved again in 84.6% of patients by 6 months and in 100% by 12 months. The authors were unable to detect a factor associated with long-term treatment-free survival of patients who stopped dasatinib treatment . Finally, the researchers did not observe any adverse events that would suggest the onset of tyrosine kinase inhibitor withdrawal syndrome, but 11 patients did experience pleural effusion after stopping dasatinib.

Moving forward, the investigators suggest that research efforts should focus on CML stem cells. A better understanding of how best to target these CML stem cells could lead to more effective treatment strategies for CML, the investigators proposed.

Disclosure: For full disclosure of the study authors, visit springer.com.



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