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UK TARGET CML Study: Comparing Real-World TKI Outcomes

By: Kelly M. Hennessey, PhD
Posted: Friday, July 31, 2020

Tyrosine kinase inhibitors (TKIs) have improved outcomes for many patients with chronic myeloid leukemia (CML), with survival rates close to those of the general population. These advances prompted the European LeukemiaNet to recommend the best use of the available ABL1-targeting TKIs. The goal of the UK TARGET CML study was to compare European LeukemiaNet 2013 recommendations with baseline patient characteristics, first- and second-line TKI therapies, and response monitoring practices. The results of the study were published by Dragana Milojkovic, PhD, of Hammersmith Hospital, London, and colleagues in the British Journal of Haematology.

This retrospective observational study included patient data from 21 National Health Service secondary and tertiary care centers throughout the United Kingdom. In total, 257 patients were enrolled in the study. Most patients (79%) received imatinib as first-line TKI therapy. Molecular cytogenetic testing occurred with at least one milestone during first-line treatment in 87% of patients (n = 223). Within the first year of first-line treatment, 97% of patients were assessed using real-time quantitative polymerase chain reaction.

In total, 48 patients did not respond to treatment, and of those, 11 remained on first-line therapy, whereas 37 switched TKIs. Among all patients, 44% switched TKIs, and 21% switched more than once. Although the guidelines increased focus on molecular responses at 3, 6, and 12 months, monitoring of patient achievement responses and how the guidelines were implemented in a real-world setting remain unclear.

“The findings of this study highlighted key areas for improvement in care for patients with CML,” explained the investigators. “In real-world practice, approximately half of patients require a change of TKI, highlighting the importance of optimal monitoring of molecular responses and treatment-related side effects to ensure proper use of TKIs and timely switching.”

Disclosure: The study authors’ disclosures can be found at onlinelibrary.wiley.com.



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