Current Strategies and Future Directions to Achieve Deep Molecular Response and Treatment-Free Remission in Chronic Myeloid Leukemia
The treatment of chronic myeloid leukemia (CML) has been radically changed by the approval of tyrosine kinase inhibitors (TKIs), which target BCR-ABL1 kinase activity. CML is now managed as a chronic disease requiring long-term treatment and close molecular monitoring. It has been shown that in a su...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-06-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2020.00883/full |
| _version_ | 1818299009179058176 |
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| author | Mario Annunziata Massimiliano Bonifacio Massimo Breccia Fausto Castagnetti Antonella Gozzini Alessandra Iurlo Patrizia Pregno Fabio Stagno Giorgina Specchia |
| author_facet | Mario Annunziata Massimiliano Bonifacio Massimo Breccia Fausto Castagnetti Antonella Gozzini Alessandra Iurlo Patrizia Pregno Fabio Stagno Giorgina Specchia |
| author_sort | Mario Annunziata |
| collection | DOAJ |
| description | The treatment of chronic myeloid leukemia (CML) has been radically changed by the approval of tyrosine kinase inhibitors (TKIs), which target BCR-ABL1 kinase activity. CML is now managed as a chronic disease requiring long-term treatment and close molecular monitoring. It has been shown that in a substantial number of patients who have achieved a stable deep molecular response (DMR), TKI treatment can be safely discontinued without loss of response. Therefore, treatment-free remission (TFR), through the achievement of a DMR, is increasingly regarded as a feasible treatment goal in many CML patients. However, only nilotinib has approval in this setting and a number of controversial aspects remain regarding treatment choices and timings, predictive factors, patient communication, and optimal strategies to achieve successful TFR. This narrative review aims to provide a comprehensive overview on how to optimize the path to DMR and TFR in patients with CML, and discusses recent data and future directions. |
| first_indexed | 2024-12-13T04:44:24Z |
| format | Article |
| id | doaj.art-6498090076d94b349386a48a428cef6f |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-13T04:44:24Z |
| publishDate | 2020-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-6498090076d94b349386a48a428cef6f2022-12-21T23:59:12ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-06-011010.3389/fonc.2020.00883524940Current Strategies and Future Directions to Achieve Deep Molecular Response and Treatment-Free Remission in Chronic Myeloid LeukemiaMario Annunziata0Massimiliano Bonifacio1Massimo Breccia2Fausto Castagnetti3Antonella Gozzini4Alessandra Iurlo5Patrizia Pregno6Fabio Stagno7Giorgina Specchia8Hematology Division, AORN Cardarelli-Napoli, Naples, ItalySection of Hematology, Department of Medicine, University of Verona, Verona, ItalyDepartment of Translational and Precision Medicine, Sapienza University, Rome, ItalyDepartment of Experimental, Diagnostic and Specialty Medicine, Institute of Hematology “L. and A. Seràgnoli”, “S. Orsola-Malpighi” Univeristy Hospital, University of Bologna, Bologna, ItalyDepartment of Cellular Therapy and Transfusional Medicine, AUO Careggi, Florence, ItalyHematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, ItalyHematology Division, Oncology and Hematology Department, AOU Città della Salute e della Scienza di Torino, Turin, ItalyDivision of Hematology and Bone Marrow Transplant, AOU Policlinico—V. Emanuele, Catania, ItalyHematology Section, Department of Emergency and Organ Transplantation, University of Bari-Aldo Moro, Bari, ItalyThe treatment of chronic myeloid leukemia (CML) has been radically changed by the approval of tyrosine kinase inhibitors (TKIs), which target BCR-ABL1 kinase activity. CML is now managed as a chronic disease requiring long-term treatment and close molecular monitoring. It has been shown that in a substantial number of patients who have achieved a stable deep molecular response (DMR), TKI treatment can be safely discontinued without loss of response. Therefore, treatment-free remission (TFR), through the achievement of a DMR, is increasingly regarded as a feasible treatment goal in many CML patients. However, only nilotinib has approval in this setting and a number of controversial aspects remain regarding treatment choices and timings, predictive factors, patient communication, and optimal strategies to achieve successful TFR. This narrative review aims to provide a comprehensive overview on how to optimize the path to DMR and TFR in patients with CML, and discusses recent data and future directions.https://www.frontiersin.org/article/10.3389/fonc.2020.00883/fullchronic myeloid leukemiadeep molecular responseoptimal strategiestreatment-free remissiontyrosine kinase inhibitors |
| spellingShingle | Mario Annunziata Massimiliano Bonifacio Massimo Breccia Fausto Castagnetti Antonella Gozzini Alessandra Iurlo Patrizia Pregno Fabio Stagno Giorgina Specchia Current Strategies and Future Directions to Achieve Deep Molecular Response and Treatment-Free Remission in Chronic Myeloid Leukemia Frontiers in Oncology chronic myeloid leukemia deep molecular response optimal strategies treatment-free remission tyrosine kinase inhibitors |
| title | Current Strategies and Future Directions to Achieve Deep Molecular Response and Treatment-Free Remission in Chronic Myeloid Leukemia |
| title_full | Current Strategies and Future Directions to Achieve Deep Molecular Response and Treatment-Free Remission in Chronic Myeloid Leukemia |
| title_fullStr | Current Strategies and Future Directions to Achieve Deep Molecular Response and Treatment-Free Remission in Chronic Myeloid Leukemia |
| title_full_unstemmed | Current Strategies and Future Directions to Achieve Deep Molecular Response and Treatment-Free Remission in Chronic Myeloid Leukemia |
| title_short | Current Strategies and Future Directions to Achieve Deep Molecular Response and Treatment-Free Remission in Chronic Myeloid Leukemia |
| title_sort | current strategies and future directions to achieve deep molecular response and treatment free remission in chronic myeloid leukemia |
| topic | chronic myeloid leukemia deep molecular response optimal strategies treatment-free remission tyrosine kinase inhibitors |
| url | https://www.frontiersin.org/article/10.3389/fonc.2020.00883/full |
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