Back to Search
Start Over
[Recommendations from the French CML Study Group (Fi-LMC) for BCR-ABL1 kinase domain mutation analysis in chronic myeloid leukemia].
- Source :
-
Bulletin du cancer [Bull Cancer] 2020 Jan; Vol. 107 (1), pp. 113-128. Date of Electronic Publication: 2019 Jul 26. - Publication Year :
- 2020
-
Abstract
- In the context of chronic myeloid leukemia (CML) resistant to tyrosine kinase inhibitors (TKIs), BCR-ABL1 tyrosine kinase domain (TKD) mutations still remain the sole biological marker that directly condition therapeutic decision. These recommendations aim at updating the use of BCR-ABL1 mutation testing with respect to new available therapeutic options and at repositioning different testing methods at the era of next generation sequencing (NGS). They have been written by a panel of experts from the French Study Group on CML (Fi-LMC), after a critical review of relevant publications. TKD mutation testing is recommended in case of treatment failure but not in case of optimal response. For patients in warning situation, mutation testing must be discussed depending on the type of TKI used, lasting of the treatment, kinetic evolution of BCR-ABL1 transcripts along time and necessity for switching treatment. The kind and the frequency of TKD mutations occasioning resistance mainly depend on the TKI in use and disease phase. Because of its better sensitivity, NGS methods are recommended for mutation testing rather than Sanger's. Facing a given TKD mutation, therapeutic decision should be taken based on in vitro sensitivity and clinical efficacy data. Identification by sequencing of a TKD mutation known to induce resistance must lead to a therapeutic change. The clinical value of testing methods more sensitive than NGS remains to be assessed.<br /> (Copyright © 2019 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Subjects :
- Antineoplastic Agents therapeutic use
Catalytic Domain
Clinical Decision-Making
DNA, Neoplasm analysis
Drug Resistance, Neoplasm genetics
Drug Substitution
Fusion Proteins, bcr-abl antagonists & inhibitors
High-Throughput Nucleotide Sequencing
Humans
Leukemia, Myelogenous, Chronic, BCR-ABL Positive drug therapy
Leukemia, Myelogenous, Chronic, BCR-ABL Positive enzymology
Molecular Biology
Protein Domains
Protein Kinase Inhibitors therapeutic use
Role
DNA Mutational Analysis methods
DNA, Neoplasm genetics
Fusion Proteins, bcr-abl genetics
Leukemia, Myelogenous, Chronic, BCR-ABL Positive genetics
Mutation, Missense
Point Mutation
Subjects
Details
- Language :
- French
- ISSN :
- 1769-6917
- Volume :
- 107
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Bulletin du cancer
- Publication Type :
- Academic Journal
- Accession number :
- 31353136
- Full Text :
- https://doi.org/10.1016/j.bulcan.2019.05.011