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Updated: Jul 1, 2025
10:49
Pre-clinical Evaluation of Tyrosine Kinase Inhibitors for Treatment of Acute Leukemia
Published on: September 18, 2013
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European Stop Tyrosine Kinase Inhibitor Trial (EURO-SKI) in Chronic Myeloid Leukemia: Final Analysis and Novel
Francois-Xavier Mahon1, Markus Pfirrmann2, Stéphanie Dulucq3,4
1Bergonié Cancer Institute, INSERM UMR1312 Inserm, University of Bordeaux, Bordeaux, France.
Summary
Stopping tyrosine kinase inhibitors (TKIs) in chronic myeloid leukemia patients in deep molecular remission (DMR) is feasible. Treatment duration and BCR::ABL1 transcript type predict maintenance of major molecular response (MMR).
Area of Science:
- Hematology
- Oncology
- Clinical Trials
Background:
- Chronic myeloid leukemia (CML) treatment often involves tyrosine kinase inhibitors (TKIs).
- Stopping TKIs in patients with stable deep molecular remission (DMR) is an area of active research.
- The European Stop Kinase Inhibitors (EURO-SKI) study is a large clinical trial investigating TKI cessation in CML.
Purpose of the Study:
- To evaluate the outcomes of stopping TKIs in patients with CML in stable DMR.
- To identify factors predicting the maintenance of major molecular response (MMR) after TKI cessation.
Main Methods:
- The EURO-SKI study enrolled 728 patients with CML in stable DMR.
- Patients stopped TKIs, and MMR was assessed at 6 and 36 months.
- Statistical analyses, including multivariate logistic regression, were used to identify predictive factors.
Main Results:
- At 6 months, 61% of patients remained in MMR; at 36 months, 46% remained in MMR.
- Duration of TKI treatment and DMR before cessation were significant predictors of MMR loss at 6 months.
- For late MMR loss and overall MMR maintenance, TKI treatment duration, BCR::ABL1 transcript type, and blast percentage at diagnosis were significant factors.
Conclusions:
- TKI cessation is a viable strategy for a significant proportion of CML patients in stable DMR.
- Treatment duration, BCR::ABL1 transcript type, and blast percentage at diagnosis are crucial for predicting treatment-free remission.
- These factors should guide clinical decisions regarding TKI cessation in CML management.
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