ASH 2016: Cessation of Tyrosine Kinase Inhibitor Treatment in Chronic Myeloid Leukemia Patients With Deep Molecular Response
In one of the largest-ever trials to assess the safety of stopping tyrosine kinase inhibitor therapy—the Euro-Ski trial—about half of 821 patients with chronic myeloid leukemia (CML) showed no evidence of relapse 2 years after treatment cessation, suggesting that some patients can safely discontinue tyrosine kinase inhibitor use. These findings were presented by Mahon et al at the 58th American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 787).
Euro-Ski Findings
Study participants who had taken a tyrosine kinase inhibitor for more than 5.8 years before stopping were significantly less likely to experience relapse within the first 6 months (relapse occurred in 34.5% of these patients) compared to those who had been on the therapy for a shorter duration (57.4%), according to the research team. Each additional year of tyrosine kinase inhibitor therapy increased a patient’s chances of successful tyrosine kinase inhibitor discontinuation by about 16%.
The study focused on CML patients whose leukemia was in deep remission. All participants had a stable, extremely low level of detectable leukemia markers for at least 1 year before tyrosine kinase inhibitor cessation. After stopping tyrosine kinase inhibitor therapy, 62% showed no evidence of leukemia recurrence at 6 months, and 52% showed no recurrence at 24 months.
Of the patients who experienced leukemia recurrence, most regained their previous remission level after resuming tyrosine kinase inhibitor therapy. No study participants, within the study follow-up period, had progression to a dangerous state of advanced disease.
“Many patients struggle between the decision to stop tyrosine kinase inhibitor use because of its side effects and the fear of remission. Because of the high number of patients included in this study, we think the results could help to inform future guideline recommendations for tyrosine kinase inhibitor use,” said lead study author Francois-Xavier Mahon, MD, PhD, of the Bergonie Cancer Center of the University of Bordeaux, France.
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