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EHA25 Virtual: Update on Second-Generation TKIs and Relapse in CML

By: Joseph Fanelli
Posted: Wednesday, July 8, 2020

According to findings presented during the virtual edition of the 25th European Hematology Association (EHA) Annual Congress (EHA25 Virtual; Abstract EP757), second-generation tyrosine kinase inhibitors (TKIs) used in the first-line setting for patients with chronic myeloid leukemia (CML) do not appear to significantly improve molecular relapse–free survival, compared with patients who received imatinib. However, according to Oleg Shukhov, MD, PhD, of the National Research Center for Hematology, Moscow, and colleagues, second-generation TKIs did offer some benefits for patients.

“Therapy with [a] second-generation TKI as a first line seems to be an effective option to reduce treatment duration in CML patients before treatment-free remission,” the authors concluded.

The study focused on patient data from 174 people diagnosed with chronic phase CML who received at least 3 years of treatment and who had sustained a deep molecular response. In addition, patients who had discontinued TKI treatment for the first time in the prospective multicenter trial RU-SKI were selected for this study. The median duration of TKI treatment was 86 months, and the median duration of deep molecular response was 45 months.

After a median follow-up of 33 months after TKI cessation, the molecular relapse–free survival rate was 62% at 6 months, 53% at 12 months, 50% at 24 months, and 48% at 36 months. The authors did not observe a loss of major molecular response for any patients after a 32-month follow-up. According to the investigators, among the factors analyzed, treatment duration and molecular response 5 versus molecular response 4 were significant factors for molecular relapse–free survival.

The authors did not report any significant difference in the 36-month molecular relapse–free survival rate for patients treated with imatinib (47%), first-line second-generation TKIs (59%), or second-line second-generation TKIs (47%). However, they noted, patients treated with first-line second-generation TKIs demonstrated a significantly shorter treatment duration (median, 44 months) than those who received imatinib (median, 93 months).

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



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