Successful treatment discontinuation in CML patients with full-dose and low-dose TKI: Results from real-world practice
Background: In clinical studies, some patients who achieve deep molecular response (DMR) can successfully discontinue tyrosine kinase inhibitor (TKI). TKI dose reduction is also an important aspect of alleviating adverse effects and improving quality of life. This study aimed to explore the outcome...
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| Format: | Article |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2023.1101743/full |
| _version_ | 1797945456096968704 |
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| author | Yilin Chen Huifang Zhao Jingming Guo Jing Zou Wenjuan He Danlei Han Fanjun Cheng Yanli Zhang Weiming Li |
| author_facet | Yilin Chen Huifang Zhao Jingming Guo Jing Zou Wenjuan He Danlei Han Fanjun Cheng Yanli Zhang Weiming Li |
| author_sort | Yilin Chen |
| collection | DOAJ |
| description | Background: In clinical studies, some patients who achieve deep molecular response (DMR) can successfully discontinue tyrosine kinase inhibitor (TKI). TKI dose reduction is also an important aspect of alleviating adverse effects and improving quality of life. This study aimed to explore the outcome after drug withdrawal in Chinese CML patients.Methods: We conducted a retrospective analysis of the outcome of 190 patients who stopped TKI. 27 patients experienced dose reduction before TKI discontinuation. The median duration of TKI treatment and MR4 before discontinuation was 82 months and 61 months.Results: With median follow-up after stopping TKI treatment of 17 months, the estimated TFR (Treatment Free Remission) were 76.9% (95%CI, 70.2%–82.4%), 68.8% (95%CI, 61.3%–75.2%), and 65.5% (95%CI, 57.4%–72.5%) at 6, 12 and 24 months. For full-dose and low-dose TKI groups, the TFR at 24 months was 66.7% and 55.8% (p = 0.320, log-rank). Most patients (56/57) quickly achieved MMR after restarting TKI treatment. Multivariable analysis showed that patients with TKI resistance had a higher risk of molecular relapse than patients without TKI resistance (p < 0.001).Conclusion: TFR rates were not impaired in patients experiencing dose reduction before TKI discontinuation compared to patients with full-dose TKI. Our data on Chinese population may provide a basis for the safety and feasibility of TKI discontinuation, including discontinuation after dose reduction, in clinical practice. |
| first_indexed | 2024-04-10T20:55:23Z |
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| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-10T20:55:23Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-3cad93f663f2421ca7c55dbf5bf352a02023-01-23T05:01:07ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-01-011410.3389/fphar.2023.11017431101743Successful treatment discontinuation in CML patients with full-dose and low-dose TKI: Results from real-world practiceYilin Chen0Huifang Zhao1Jingming Guo2Jing Zou3Wenjuan He4Danlei Han5Fanjun Cheng6Yanli Zhang7Weiming Li8Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Hematology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Hematology, Yichang Central People’s Hospital & First Clinical Medical College of China Three Gorges University, Yichang, Hubei, ChinaDepartment of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Hematology, Yichang Central People’s Hospital & First Clinical Medical College of China Three Gorges University, Yichang, Hubei, ChinaDepartment of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Hematology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaBackground: In clinical studies, some patients who achieve deep molecular response (DMR) can successfully discontinue tyrosine kinase inhibitor (TKI). TKI dose reduction is also an important aspect of alleviating adverse effects and improving quality of life. This study aimed to explore the outcome after drug withdrawal in Chinese CML patients.Methods: We conducted a retrospective analysis of the outcome of 190 patients who stopped TKI. 27 patients experienced dose reduction before TKI discontinuation. The median duration of TKI treatment and MR4 before discontinuation was 82 months and 61 months.Results: With median follow-up after stopping TKI treatment of 17 months, the estimated TFR (Treatment Free Remission) were 76.9% (95%CI, 70.2%–82.4%), 68.8% (95%CI, 61.3%–75.2%), and 65.5% (95%CI, 57.4%–72.5%) at 6, 12 and 24 months. For full-dose and low-dose TKI groups, the TFR at 24 months was 66.7% and 55.8% (p = 0.320, log-rank). Most patients (56/57) quickly achieved MMR after restarting TKI treatment. Multivariable analysis showed that patients with TKI resistance had a higher risk of molecular relapse than patients without TKI resistance (p < 0.001).Conclusion: TFR rates were not impaired in patients experiencing dose reduction before TKI discontinuation compared to patients with full-dose TKI. Our data on Chinese population may provide a basis for the safety and feasibility of TKI discontinuation, including discontinuation after dose reduction, in clinical practice.https://www.frontiersin.org/articles/10.3389/fphar.2023.1101743/fullchronic myeloid leukemiatyrosine kinase inhibitordose reductiontreatment free remissionreal-world practice |
| spellingShingle | Yilin Chen Huifang Zhao Jingming Guo Jing Zou Wenjuan He Danlei Han Fanjun Cheng Yanli Zhang Weiming Li Successful treatment discontinuation in CML patients with full-dose and low-dose TKI: Results from real-world practice Frontiers in Pharmacology chronic myeloid leukemia tyrosine kinase inhibitor dose reduction treatment free remission real-world practice |
| title | Successful treatment discontinuation in CML patients with full-dose and low-dose TKI: Results from real-world practice |
| title_full | Successful treatment discontinuation in CML patients with full-dose and low-dose TKI: Results from real-world practice |
| title_fullStr | Successful treatment discontinuation in CML patients with full-dose and low-dose TKI: Results from real-world practice |
| title_full_unstemmed | Successful treatment discontinuation in CML patients with full-dose and low-dose TKI: Results from real-world practice |
| title_short | Successful treatment discontinuation in CML patients with full-dose and low-dose TKI: Results from real-world practice |
| title_sort | successful treatment discontinuation in cml patients with full dose and low dose tki results from real world practice |
| topic | chronic myeloid leukemia tyrosine kinase inhibitor dose reduction treatment free remission real-world practice |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2023.1101743/full |
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