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Discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia: Recommendations for clinical practice from the French Chronic Myeloid Leukemia Study Group
Author(s) -
Rea Delphine,
Ame Shanti,
Berger Marc,
Cayuela JeanMichel,
Charbonnier Aude,
Coiteux Valérie,
ConyMakhoul Pascale,
Dubruille Viviane,
Dulucq Stéphanie,
Etienne Gabriel,
Legros Laurence,
Nicolini Franck,
RocheLestienne Catherine,
EscoffreBarbe Martine,
Gardembas Martine,
GuerciBresler Agnès,
JohnsonAnsah Hyacinthe,
RigalHuguet Françoise,
Rousselot Philippe,
Mahon FrançoisXavier
Publication year - 2018
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.31411
Subject(s) - discontinuation , medicine , myeloid leukemia , oncology , tyrosine kinase inhibitor , clinical practice , intensive care medicine , cancer , immunology , family medicine
BACKGROUND The ultimate goal of chronic myeloid leukemia management in the tyrosine kinase inhibitor (TKI) era for patients who obtain deep molecular responses is maintaining a durable off‐treatment response after treatment discontinuation; this situation is called treatment‐free remission (TFR). Knowledge accumulated during the last 10 years justifies moving TFR strategies from research to clinical practice. METHODS Twenty experts from the French Chronic Myeloid Leukemia Study Group (France Intergroupe des Leucémies Myéloïdes Chroniques), including 17 hematologists, 2 molecular biologists, and 1 cytogeneticist, critically reviewed published data with the goal of developing evidence‐based recommendations for TKI discontinuation in clinical practice. RESULTS Clinically relevant questions were addressed, including the selection of candidate patients (with known prognostic factors for outcomes taken into account), detailed monitoring procedures during the treatment‐free phase, a definition of relapse requiring therapy resumption, and monitoring after treatment reintroduction. CONCLUSIONS This work presents consensus statements with the aim of guiding physicians and biologists by means of pragmatic recommendations for safe TKI discontinuation in daily practice. Cancer 2018;124:2956‐63. © 2018 American Cancer Society .