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Christopher S. Seet, MD, PhD, hematologist and oncologist, UCLA Health, discusses the need for long-term outcome data pertaining to treatment discontinuation in chronic myeloid leukemia (CML).
Christopher S. Seet, MD, PhD, hematologist and oncologist, UCLA, discusses the need for long-term outcome data pertaining to treatment discontinuation in chronic myeloid leukemia (CML).
The phase II ENESTop trial demonstrated that treatment cessation with a TKI is safe and feasible in a select population of patients with CML. Notably, the criteria for discontinuation were very strict, says Seet. As such, it remains unknown whether these criteria can be relaxed, thereby making more patients eligible for the approach. Currently, the time on TKI therapy and depth of molecular response are highly predictive of maintaining a treatment-free remission (TFR), adds Seet.
The second aspect regarding treatment discontinuation is the long-term outcome of stopping TKI therapy. Studies like ENESTop are not designed to look at long-term outcomes beyond 5 years. Although studies have demonstrated that patients can enjoy durable TFRs, they will not provide any insight into the long-term relapse rate. This will need to be clarified moving forward if treatment cessation is to remain a viable approach, he concludes.