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EHA25 Virtual: Nilotinib Induction Therapy for Chronic Phase CML

By: Joseph Fanelli
Posted: Thursday, July 2, 2020

According to findings presented during the virtual edition of the 25th European Hematology Association Annual Congress (EHA25 Virtual; Abstract EP763), although patients with chronic phase chronic myeloid leukemia (CML) achieved deeper response and early molecular response when treated with nilotinib induction therapy rather than upfront imatinib, those benefits did not seem to last. The early advantages were not present after patients switched to imatinib, noted Aditi Jain, PhD, of the All India Institute of Medical Sciences, New Delhi, and colleagues.

In this trial, the authors separated patients with chronic phase CML into three treatment groups at the time of diagnosis. Patients either received imatinib upfront, nilotinib for the first 3 months before switching to imatinib, or nilotinib for 6 months before transitioning to imatinib.

Patients who received nilotinib induction therapy reached deeper responses than those treated with imatinib after 3 and 6 months; however, subsequent molecular responses were similar for each group. Patients treated with nilotinib were found to have significantly better early molecular response (EMR) rates than those treated with imatinib. For patients treated with imatinib, 80.5% exhibited EMR 1, compared with 100% and 95.6% of those treated with nilotinib at 3 and 6 months, respectively. The authors found similar results for EMR 2 (34.2% with imatinib, 42.1% with nilotinib at 3 months, and 60% with nilotinib at 6 months). EMR 1 was defined as BCR-ABL real-time quantitative polymerase chain reaction less than 10% at 3 months; EMR 2, less than 1% at 6 months; and EMR 3, less than 0.1% at 6 months.

The authors learned that patients who achieved an EMR rate of less than 1% at 3 months or less than 0.1% at 6 months tended to have higher event-free survival and lower rates of tyrosine kinase inhibitor failure or disease progression, regardless of the type of treatment.

Disclosure: For full disclosure of the study authors, visit library.ehaweb.org.



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