Treatment-free remission after a second TKI discontinuation attempt in patients with Chronic Myeloid Leukemia re-treated with dasatinib - interim results from the DAstop2 trial

• Verfasst von: Flygt, Hjalmar [VerfasserIn]
• Verfasst von: Söderlund, Stina [VerfasserIn]
• Verfasst von: Richter, Johan [VerfasserIn]
• Verfasst von: Saußele, Susanne [VerfasserIn]
• Verfasst von: Koskenvesa, Perttu [VerfasserIn]
• Verfasst von: Stenke, Leif [VerfasserIn]
• Verfasst von: Mustjoki, Satu [VerfasserIn]
• Verfasst von: Dimitrijevic, Andreja [VerfasserIn]
• Verfasst von: Stentoft, Jesper [VerfasserIn]
• Verfasst von: Majeed, Waleed [VerfasserIn]
• Verfasst von: Roy, Lydia [VerfasserIn]
• Verfasst von: Wolf, Dominik [VerfasserIn]
• Verfasst von: Dreimane, Arta [VerfasserIn]
• Verfasst von: Gjertsen, Bjørn Tore [VerfasserIn]
• Verfasst von: Gedde-Dahl, Tobias [VerfasserIn]
• Verfasst von: Ahlstrand, Erik [VerfasserIn]
• Verfasst von: Markevärn, Berit [VerfasserIn]
• Verfasst von: Hjorth-Hansen, Henrik [VerfasserIn]
• Verfasst von: Janssen, Jeroen [VerfasserIn]
• Verfasst von: Olsson-Strömberg, Ulla [VerfasserIn]
• Titel: Treatment-free remission after a second TKI discontinuation attempt in patients with Chronic Myeloid Leukemia re-treated with dasatinib - interim results from the DAstop2 trial
• Titelzusatz: chronic myelogenous leukemia
• Verf.angabe: Hjalmar Flygt, Stina Söderlund, Johan Richter, Susanne Saussele, Perttu Koskenvesa, Leif Stenke, Satu Mustjoki, Andreja Dimitrijevic, Jesper Stentoft, Waleed Majeed, Lydia Roy, Dominik Wolf, Arta Dreimane, Bjørn Tore Gjertsen, Tobias Gedde-Dahl, Erik Ahlstrand, Berit Markevärn, Henrik Hjorth-Hansen, Jeroen Janssen and Ulla Olsson-Strömberg
• E-Jahr: 2024
• Jahr: April 2024
• Umfang: 7 S.
• Fussnoten: Online veröffentlicht: 26. Januar 2024 ; Gesehen am 12.11.2024
• Titel Quelle: Enthalten in: Leukemia
• Ort Quelle: London : Springer Nature, 1997
• Jahr Quelle: 2024
• Band/Heft Quelle: 38(2024), 4 vom: Apr., Seite 781-787
• ISSN Quelle: 1476-5551
• DOI: doi:10.1038/s41375-024-02145-6
• Datenträger: Online-Ressource
• Sprache: eng
• Bibliogr. Hinweis: Errata: Flygt, Hjalmar: Correction: Treatment-free remission after a second TKI discontinuation attempt in patients with Chronic Myeloid Leukemia re-treated with dasatinib - interim results from the DAstop2 trial
• Sach-SW: Myeloproliferative disease
• Sach-SW: Targeted therapies
• K10plus-PPN: 190828711X

Abstract

Tyrosine kinase inhibitor (TKI) discontinuation in chronic myeloid leukemia (CML) has become part of routine care for patients with a sustained deep molecular response (DMR). Approximately 50% experience a molecular relapse upon TKI cessation. Most of them quickly regain DMR upon TKI resumption. Whether these patients can achieve a second treatment-free remission (TFR) remains unclear. DAstop2 (ClinicalTrials.gov ID: NCT03573596) is a prospective study including patients with a failed first TFR attempt re-treated with any TKI for ≥ one year. Upon entering the study, patients received the TKI dasatinib for additional two years. Patients with sustained DMR for ≥1 year qualified for a second TKI stop. Ninety-four patients were included between Oct 2017-Dec 2021. At the time of data analysis, 62 patients had attempted a 2nd stop. After a median follow-up of 27 months from 2nd stop, TFR rates were 61, 56 and 46% at 6, 12 and 24 months respectively. No progression to advanced stage disease was seen and 87% had re-achieved MR4 within a median of 3 months from TKI re-initiation. In summary, we show that a 2nd TFR attempt after dasatinib treatment is safe, feasible and TFR rates seem in the range of those reported in trials of a first TKI stop.