A de-escalation of tyrosine-kinase inhibitor (TKI) dose was safe in the majority of patients with chronic myeloid leukemia with stable major molecular response (MMR), according to the results of a study published recently in Lancet Haematology.
According to the study, discontinuation of TKIs has been found to be feasible in patients with chronic myeloid leukemia with deep molecular response, but has not been studied in patients with MMR.
"In patients with chronic myeloid leukemia with stable MMR or better, a reduction in TKI treatment to half the standard dose appears safe, and is associated with improvement in TKI-related side effects," wrote authors led by Richard E. Clark, MD, of the Institute of Translational Medicine and Cancer Research in the United Kingdom. "This finding implies that many patients with stable responses might be able to maintain their responses on lower TKI doses."
http://www.cancernet...ecular-response
TKI De-escalation Safe in Most CML Patients With Major Molecular Response
Started by
gerry
, Jul 25 2017 05:18 PM
4 replies to this topic
#3
Kali
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Posted 25 July 2017 - 09:54 PM
Great article! Thanks for sharing😊
Diagnosed June 2014. WBC 34.6 and Platelets 710 at diagnosis. Bone Marrow Biopsy pre-op diagnosis: Leukocytosis. Post-op diagnosis: the same, Leukocytosis. No increase in blasts <1%. Quantitative BCR/ABL testing and formal chromosome analyses confirmed CML diagnosis.<p>Supplemental Report: Abnormal BCR/ABL1 FISH result t(9;22). Molecular test for BCR/ABL1 fusion transcript by RT-PCR positive for BCR/ABL1 transcripts, b3a2 at 133.561% and b2a2 at 0.001% and ela2 at 0.001%. Followup monitoring showed negative for ela2. BCRABL1 was 148.007 at diagnosis. Started Sprycel 100 mgm and blood work was normal at 3 weeks. MMR at 3 months: 10/4/14 was 0.106. Stayed in that range with one dip to 0.04 once and back to 0.1 range. Oct. 2015, BCRABL1 was not detected, following with 0.0126, 0.0092, <0.0069, 0.0000, <0.0069, 0.0000. Now on 70 mgm of Sprycel. Continuation of PCR test results: 07/07/2017, 0.0000%, now on 50 mgm of Sprycel, PCR 9/12/17 0.0074%, PCR 11/3/17 0.0000%, PCR 1/17/2018 0.0000%
#4
TeddyB
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Posted 26 July 2017 - 04:26 AM
Thank you Gerry.
Any new de-escalation trials on the way?
After such a success (even with those in MMR) it would almost seem stupid not to study de-escalation further, in regards to both side effects and costs.
#5
gerry
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Posted 26 July 2017 - 05:16 PM
Teddy - most trials that I can find are for stopping TKI at the moment, but I figure following the Destiny success others will be doing deescalation trials down the track. It would be a matter of writing up the trial and finding backers. A lot of the countries conducting STOP trials would be keen to get as many people off safely first, to save money on our subsidised health care systems.
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