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Second- or third-generation tyrosine kinase inhibitors in first-line treatment of chronic myeloid leukemia in general population: Is there a real benefit?
- Source :
-
Cancer medicine [Cancer Med] 2021 Oct; Vol. 10 (20), pp. 6959-6970. Date of Electronic Publication: 2021 Sep 22. - Publication Year :
- 2021
-
Abstract
- Introduction: Since 2009, multiple randomized trials have shown faster and deeper responses in CML patients treated with new-generation TKI (NG-TKI) compared to those treated with imatinib (IM). Are the same results observed in the general population?<br />Materials and Methods: Patients were identified from the three French hematological malignancies population-based registries. All CML patients (ICD-O-3: 9875/3) diagnosed between 2006 and 2016 and resided in registries areas were included. The TKI generation effect on achievement of MMR in first-line therapy was assessed through a multivariate competitive risk analysis. An alluvial plot described the pathways leading to death.<br />Results: In total, 507 CML patients received TKI in first-line treatment, 22% were enrolled in a clinical trial. After adjustment, NG-TKI patients were significantly more likely to achieve MMR during first-line therapy than IM patients (HR: 1.88 CI <subscript>95%</subscript> [1.35-2.61]). At the end of follow-up, 212 patients were still in first-line therapy (46 of them died), 203 switched to second-line (43 subsequently died), 26 were on TFR from first-line (4 subsequently died), and 20 stopped their treatment (16 subsequently died).<br />Discussion: In this comprehensive real-life setting, the results were consistent with clinical trials. The results are not sufficient to conclude that a NG-TKI treatment is superior with regard to these patients, despite indications regarding differences between the TKI generation effect on survival and tolerance.<br /> (© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
- Subjects :
- Adult
Aged
Aniline Compounds therapeutic use
Dasatinib therapeutic use
Female
France
Humans
Imidazoles therapeutic use
Leukemia, Myelogenous, Chronic, BCR-ABL Positive mortality
Male
Middle Aged
Multivariate Analysis
Nitriles therapeutic use
Pyridazines therapeutic use
Pyrimidines therapeutic use
Quinolines therapeutic use
Registries
Remission Induction
Treatment Outcome
Leukemia, Myelogenous, Chronic, BCR-ABL Positive drug therapy
Protein Kinase Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 2045-7634
- Volume :
- 10
- Issue :
- 20
- Database :
- MEDLINE
- Journal :
- Cancer medicine
- Publication Type :
- Academic Journal
- Accession number :
- 34551198
- Full Text :
- https://doi.org/10.1002/cam4.4186