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Recent Data Support TKI Discontinuation in Patients With CML

Brandon Scalea
Published: Monday, Sep 24, 2018

Kendra Sweet, MD

Kendra Sweet, MD
Discontinuation of treatment with a tyrosine kinase inhibitor (TKI) is feasible for a subset of patients with chronic myeloid leukemia (CML), explained Kendra Sweet, MD.

State of the Science Summit™ on Hematologic Malignancies, Sweet, an assistant member in the Department of Malignant Hematology of Moffitt Cancer Center, shed light on these data regarding treatment discontinuation and how they impact patients with CML.

OncLive: Why is there a focus on discontinuing TKI therapy in CML?

Sweet: There are a number of clinical trials that have been looking at the possibility of discontinuing this class of drugs in a select subset of patients with deep molecular responses who have maintained those responses for a certain period of time. Basically, in every study that’s been done here, the results are strikingly similar. We have consistently seen about 50% of patients relapse, particularly early on. The others are able to maintain what we call a prolonged treatment-free remission. Therefore, in my presentation, I reviewed these different trials that have been completed and published.

Could you highlight some of these trials?

The first discontinuation trial was the STIM1 trial, which was a study done in France starting in 2007. They enrolled 100 patients who were all being treated with imatinib. These patients maintained those deep responses we mentioned earlier for a minimum of 2 years. They then discontinued imatinib and were followed off treatment until molecular relapse. The data from that study are the oldest data we have now. The long-term follow-up was published about 1.5 years ago. There was a 77-month median follow-up time, and 38% of patients remained off treatment. That was the first sort of proof-of-principle study showing that discontinuing therapy for a subset of patients is feasible.
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