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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.
- Source :
-
Cancer medicine [Cancer Med] 2015 Jul; Vol. 4 (7), pp. 995-1002. Date of Electronic Publication: 2015 Mar 10. - Publication Year :
- 2015
-
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.<br /> (© 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Antineoplastic Agents administration & dosage
Drug Substitution
Female
Gene Expression Regulation, Neoplastic
Humans
Imatinib Mesylate administration & dosage
Imatinib Mesylate therapeutic use
Leukemia, Myelogenous, Chronic, BCR-ABL Positive mortality
Male
Middle Aged
Protein Kinase Inhibitors administration & dosage
Retreatment
Retrospective Studies
Time Factors
Transcription, Genetic
Treatment Failure
Treatment Outcome
Young Adult
Antineoplastic Agents therapeutic use
Fusion Proteins, bcr-abl genetics
Genes, abl
Leukemia, Myelogenous, Chronic, BCR-ABL Positive drug therapy
Leukemia, Myelogenous, Chronic, BCR-ABL Positive genetics
Protein Kinase Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 2045-7634
- Volume :
- 4
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Cancer medicine
- Publication Type :
- Academic Journal
- Accession number :
- 25756742
- Full Text :
- https://doi.org/10.1002/cam4.440