7 replies to this topic

[Buzzm1]

Chinese patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs) had a higher incidence of second malignancies, in contrast with the expected incidence among the general Chinese population, a study published in the journal Clinical Lymphoma, Myeloma & Leukemia has shown.1

TKIs revolutionized the treatment  of patients with CML by potentiating long-term survival. Most patients treated with TKIs have tolerated the agents satisfactorily, though the risk of second malignancies suggests that risk assessment is important.

Researchers evaluated the incidence and potential risk factors of second malignancies in 223 patients with Philadelphia chromosome-positive CML treated with a TKI, particularly imatinib. Investigators compared the data of second malignancies among patients with expected incidence from the National Central Cancer Registry of ChinaResults showed that after a median follow-up of 64 months from the time of CML diagnosis, 3.14% developed 6 distinct second malignancies, including breast, cervical, colon, gastric, kidney, and lymphonodus tissue. It was found that the risk of second malignancy was higher than expected with an observed-to-expected ratio of 2.45 (95% CI, 1.17-5.14; P = .018).

Researchers were not able to identify potential risk factors, such as length of exposure or cumulative dose of TKI, that were associated with risk for development of a second malignancy in CML patients treated with imatinib.  

http://www.cancerthe...article/502444/                           

Reference

1. Yin X-F, Wang J-H, Li X, Yu M-X, Ma Z-X, Jin J. Incidence of second malignancies of chronic myeloid leukemia during treatment with tyrosine kinase inhibitors [published online ahead of print June 8, 2016]. Clin Lymphoma Myeloma Leuk. doi: 10.1016/j.clml.2016.06.010.

[scuba]

All the more reason to get off these drugs as soon as practical.

[Buzzm1]

If anyone needs an incentive to reduce their dosage, as soon, and as often, as feasibly possible, the article should help.  

[thatguy]

_{I  wonder if this can be taken at face value (as a result of TKI treatment) or if this simply corresponds to, we who  have CML are inherently more likely to have other onco-genetic issues. As where non-tki treatment didn't typically prolong life long enough to develop another malignancy?}

[gerry]

Another question is why is this only shown up here. Other countries should show similar results.

[Trey]

I have seen this data all over the map, from less chance to more chance of secondary cancers.  Here is another recent and much larger study (1445 patients) which says there is less secondary cancer risk than expected for those with CML taking TKI drugs:

 

"The risk of second cancer was lower than expected (observed-to-expected ratio, 0.6; 95% confidence interval, 0.44-0.81). Second cancers occur in a small percentage of patients receiving therapy with TKIs for hematologic malignancies, mostly CML. No evidence at the moment suggests that exposure to TKIs increases the risk of developing second cancers."

http://www.bloodjour...so-checked=true

 

Even those studies which suggest there may be an increased risk (such as the one linked in the first post on this thread) say the increased risk is about 3 in 1000 to 6 in 1000 patients developing secondary cancers.  So we are talking very small differences and also conflicting information. 

[rcase13]

I choose to believe Trey's study...

[thatguy]

China study: propoganda, designed to deter tki use, so the socialized medical economy doesn't bare the brunt of med cost to as many....that's my loony right wing / denial theory. Lol