Switching to second‐generation tyrosine kinase inhibitor improves the response and outcome of frontline imatinib‐treated patients with chronic myeloid leukemia with more than 10% of BCR‐ABL/ABL ratio at 3 months

Cancer Medicine

Luis-Felipe Casado¹  José-Valentín García-Gutiérrez¹  Isabel Massagué¹  Pilar Giraldo¹  Manuel Pérez-Encinas¹  Raquel de Paz¹  Joaquín Martínez-López¹  Guiomar Bautista¹  Santiago Osorio¹  María-José Requena¹  Luis Palomera¹  María-Jesús Peñarrubia¹  Carmen Calle¹  José-Ángel Hernández-Rivas¹  Carmen Burgaleta¹  Begoña Maestro¹  Nuria García-Ormeña¹ 

[1] Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain

关键词: BCR‐ABL/ABL ratio;    chronic myeloid leukemia;    dasatinib;    imatinib;    nilotinib;   

DOI  :  10.1002/cam4.440

来源: Wiley

【 摘 要 】

Abstract

Chronic myeloid leukemia patients display heterogeneous responses to imatinib. Survival depends on baseline clinical characteristics (including prognostic scoring systems) and on early response (such as >10% BCR-ABL/ABL ratio at 3 months of therapy). The results of switching to second-generation tyrosine kinase inhibitors (2GTKIs) may contain a bias since, in the majority of these studies, patients who switch treatment due to intolerance or failure are censored or excluded. We analyzed the Spanish Registry data on switching in an intention-to-treat analysis of patients in standard clinical practice. Switching to 2GTKIs improves responses from 45% to 75% of complete cytogenetic response (CCyR) and from 15% to 45% of major molecular response (MMR) in the group without molecular response 1 (MR1) at 3 months and from 70% to 87% in CCyR and from 52% to 87% in MMR in the group with MR1. The final response rate is poorer in the group with no MR1 at 3 months. Nevertheless, the differences in the rates of response were not translated into differences in major events (transformations or deaths), and the final progression-free survival and overall survival were similar.

【 授权许可】

CC BY   
© 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

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