Tyrosine Kinase Inhibitor Discontinuation in Patients With Chronic Myeloid Leukemia: Updates From the LAST Study on Patient-Reported Outcomes and Biomarkers for Relapse
Mené aux Etats-Unis sur 172 patients atteints d'une leucémie myéloïde chronique (âge médian : 60 ans), cet essai non randomisé évalue l'efficacité, du point de vue de la récidive moléculaire, et l'intérêt, du point de vue des symptômes déclarés par les patients, de l'arrêt du traitement par inhibiteurs de tyrosine kinase (durée minimale de suivi : 3 ans)
More than 20 years ago, the first patients were enrolled in the phase 1 trial of imatinib for treatment of chronic myeloid leukemia (CML).1 Inhibiting the kinase activity of the BCR-ABL1 fusion protein, the driving molecular abnormality of this disease, has rendered this once deadly leukemia a manageable condition. For patients with CML, a good disease outcome with nearly normal lifespan is expected, but treatment adverse effects remain a significant issue.2 While adverse effect profiles vary between drugs, many patients report decreased energy, diffuse pain, gastrointestinal upset, depressed mood, and additional adverse effects that are detrimental to their quality of life. Driven by a desire to decrease the burden of adverse effects, there has been extensive interest in whether some patients might safely discontinue treatment and experience long periods of treatment-free remission (TFR).
JAMA Oncology , commentaire, 2019