Onkologie. 2014:8(3):129-130

Discontinuation of biological therapy with tyrosine kinase inhibitors in chronic myeloid leukemia patients

Pavel Dvořák^1,2, Daniel Lysák³, Samuel Vokurka³, Věra Vozobulová³

¹ Ústav lékařské genetiky LF UK v Plzni a FN Plzeň

² Ústav biologie LF UK v Plzni

³ Hematologicko-onkologické oddělení FN Plzeň

Imatinib mesylate, the first tyrosine kinase inhibitor (TKI) approved for the treatment of chronic myeloid leukemia (CML), became the

standard of care, induces durable responses and prolongs event-free survival and progression-free survival. However, if TKI therapy is

required indefinitely, then this ongoing drug exposure raises its own problems. Long-term follow-up indicates that an increasing proportion

of patients treated with TKI have prompt cytogenetic response and achieve reductions in BCR-ABL1 transcripts to a level that is

undetectable by very sensitive molecular genetic methods. Observation of the stability of such responses over long follow-up suggests that

such patients may be “functionally cured“ of CML and thus potentially eligible for TKI therapy discontinuation. At present, therapy discontinuation

in CML is not recommended in routine practice and is under active investigation in several clinical studies worldwide. Many

questions remain regarding definition of “functional cure“ in CML, which patients are most eligible for safe therapy discontinuation, and

what management strategies are recommended post discontinuation, especially regarding subsequent molecular relapse.

Keywords: chronic myeloid leukemia, tyrosine kinase inhibitors, treatment discontinuation

Published: June 1, 2014  Show citation