Stemming the regrowth of leukemia

David J Dorer, Ronalk K. Knickerbocker, Michele Baccarani, Jorge E. Cortes, Andreas Hochhaus, Moshe Talpaz, Frank G. Haluska

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  Ponatinib dose intensity was shown to be associated with rates of adverse events.

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  Pancreatitis, rash, and cardiac failure were most strongly associated with dose.

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  Time-to-event analyses suggest a lag between changes in dose and event risk.

Most reports on chronic myeloid leukaemia (CML) treatment with tyrosine kinase inhibitors (TKIs) focus on efficacy, particularly on molecular response and outcome. In contrast, adverse events (AEs) are often reported as infrequent, minor, tolerable and manageable, but they are increasingly important as therapy is potentially lifelong and multiple TKIs are available. For this reason, the European LeukemiaNet panel for CML management recommendations presents an exhaustive and critical summary of AEs emerging during CML treatment, to assist their understanding, management and prevention.

The advent of tyrosine kinase inhibitors (TKI) into the management of patients with chronic myeloid leukemia (CML) has profoundly improved prognosis. Survival of responders is approaching that of the general population but lifelong treatment is still recommended. In several trials, TKI treatment has been stopped successfully in approximately half of the patients with deep molecular response. This has prompted the development of a new concept in the evaluation of CML patients known as ‘treatment-free remission’.

Neil P. Shah,1* Philippe Rousselot,2 Charles Schiffer,3 Delphine Rea,4 Jorge E. Cortes,5 Jorge Milone,6 Hesham Mohamed,7 Diane Healey,7 Hagop Kantarjian,5 Andreas Hochhaus,8 and Giuseppe Saglio,9

Dasatinib was approved at 100 mg once daily for imatinib-resistant or -intolerant patients with chronicmyeloid leukemia (CML) in chronic phase, based on results of the phase 3 CA180-034 (NCT00123474) study. Here we present the final 7-year analysis of this pivotal study, the longest follow-up to date of any second-generation BCR–ABL1 tyrosine kinase inhibitor (TKI).

News | May 03, 2016 

The addition of pegylated interferon-ɑ2b (PegIFN) to the tyrosine kinase inhibitor (TKI) dasatinib yielded promising results in a small trial of newly diagnosed chronic myeloid leukaemia (CML) patients.

A Hochhaus, G Saglio, T P Hughes, R A Larson, D-W Kim, S Issaragrisil, P D le Coutre, G Etienne, P E Dorlhiac-Llacer, R E Clark, I W Flinn, H Nakamae, B Donohue, W Deng, D Dalal, H D Menssen and H M Kantarjian

Abstract

Response definitions for any TKI first line - and 2nd line in case of intolerance, all patients (CP, AP, and BC)

http://www.leukemia-net.org/content/leukemias/cml/recommendations/e8078/infoboxContent10432/PocketCard_UPDATE2013_English.pdf

Also

Original Article

Leukemia (2016) 30, 

823–832; doi:10.1038/leu.2015.329;published online 19 January 2016