Open AccessSwitching to second‐generation tyrosine kinase inhibitor improves the response and outcome of frontline imatinib‐treated patients with chronic myeloid leukemia with more than 10% of BCR‐ABL/ABL ratio at 3 months
Author(s) -
Casado LuisFelipe,
GarcíaGutiérrez JoséValentín,
Massagué Isabel,
Giraldo Pilar,
PérezEncinas Manuel,
Paz Raquel,
MartínezLópez Joaquín,
Bautista Guiomar,
Osorio Santiago,
Requena MaríaJosé,
Palomera Luis,
Peñarrubia MaríaJesús,
Calle Carmen,
HernándezRivas JoséÁngel,
Burgaleta Carmen,
Maestro Begoña,
GarcíaOrmeña Nuria,
Steegmann JuanLuis
Publication year - 2015
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.440
Subject(s) - imatinib , tyrosine kinase inhibitor , myeloid leukemia , tyrosine kinase , medicine , cancer research , abl , oncology , receptor , cancer
Chronic myeloid leukemia patients display heterogeneous responses to imatinib. Survival depends on baseline clinical characteristics (including prognostic scoring systems) and on early response (such as >10% BCR‐ABL/ABL ratio at 3 months of therapy). The results of switching to second‐generation tyrosine kinase inhibitors (2 GTKI s) may contain a bias since, in the majority of these studies, patients who switch treatment due to intolerance or failure are censored or excluded. We analyzed the S panish R egistry data on switching in an intention‐to‐treat analysis of patients in standard clinical practice. Switching to 2 GTKI s improves responses from 45% to 75% of complete cytogenetic response (CCyR) and from 15% to 45% of major molecular response (MMR) in the group without molecular response 1 (MR1) at 3 months and from 70% to 87% in CCyR and from 52% to 87% in MMR in the group with MR1. The final response rate is poorer in the group with no MR1 at 3 months. Nevertheless, the differences in the rates of response were not translated into differences in major events (transformations or deaths), and the final progression‐free survival and overall survival were similar.