Optimizing olverembatinib dose in chronic phase chronic myeloid leukemia

Optimizing olverembatinib dose in people with chronic phase chronic myeloid leukemia is important to increase safety without compromising efficacy. We designed a multicenter, retrospective study comparing safety and efficacy of olverembatinib between the recommended dose of 40 mg every other day (QOD; N=216) and a reduced dose of 30 mg QOD (N=66) in subjects failing to have benefited from other tyrosine kinase inhibitors. The cohorts were similar with regard to baseline co-variates and adjusted for by propensity score matching. There were no significant differences in cytogenetic and molecular responses, or in outcomes between the two dose cohorts. However, the proportion of subjects receiving the original olverembatinib dose at the last follow-up was significantly higher in the 30 mg cohort: 64% (95% confidence interval [95% CI]: 53-75%) versus 44% (95% CI: 37-51%; P=0.004). Furthermore, the proportion of subjects receiving a reduced dose or permanently discontinuing because of adverse events was significantly lower in the 30 mg cohort: 21% (95% CI: 9-33%) versus 41% (95% CI: 34-48%; P=0.003). In summary, a starting dose of olverembatinib 30 mg QOD is as effective as a 40 mg starting dose but better tolerated in people with chronic phase chronic myeloid leukemia in whom other tyrosine kinase inhibitors have failed.