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Final 3-year Results of the Dasatinib Discontinuation Trial in Patients With Chronic Myeloid Leukemia Who Received Dasatinib as a Second-line Treatment

التفاصيل البيبلوغرافية
العنوان: Final 3-year Results of the Dasatinib Discontinuation Trial in Patients With Chronic Myeloid Leukemia Who Received Dasatinib as a Second-line Treatment
المؤلفون: Satoshi Hashino, Hirohito Yamazaki, Kensuke Usuki, Kazuo Tsubaki, Yokiko Ohe, Masato Shikami, Hideo Tanaka, Masaya Okada, Toshihiro Fukushima, Masayuki Hino, Hisashi Sakamaki, S Mizuta, Naokuni Uike, Junichi Sakamoto, Tetsuhiko Nomura, Takahiko Utsumi, Hirohisa Nakamae, Yosuke Minami, Yasuhiro Maeda, Toshimasa Kukita, Jun Imagawa, Takashi Kumagai, Takahiro Okamoto, Satoshi Morita, Hiroshi Akasaka, Yoko Adachi, Masaharu Nohgawa, Satoshi Yoshihara, Toshiki Nataduka, Yukari Shirasugi, Masahiro Ogasawara, Hisashi Wakita, Hiroshi Kosugi, Tomoharu Takeoka, Shinya Kimura, Yoji Ishida, Yasushi Onishi, Kazunori Murai, Tsutomu Sato, Hisashi Fukutani, Sachiko Ando, Seiichi Sato, Hisayuki Yokoyama, Yasunori Nakagawa, Hiroto Sakoda, Kazuteru Ohashi, Hirohiko Shibayama, Nobuhiko Uoshima
المصدر: Clinical Lymphoma Myeloma and Leukemia. 18:353-360.e1
بيانات النشر: Elsevier BV, 2018.
سنة النشر: 2018
مصطلحات موضوعية: Male, 0301 basic medicine, Oncology, Cancer Research, medicine.medical_specialty, Dasatinib, Fusion Proteins, bcr-abl, Antineoplastic Agents, 03 medical and health sciences, Deprescriptions, 0302 clinical medicine, Recurrence, Risk Factors, Interquartile range, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, hemic and lymphatic diseases, Multicenter trial, Internal medicine, medicine, Humans, Protein Kinase Inhibitors, business.industry, Remission Induction, Myeloid leukemia, Imatinib, Hematology, Middle Aged, Interim analysis, Discontinuation, Treatment Outcome, 030104 developmental biology, Nilotinib, 030220 oncology & carcinogenesis, Female, business, Follow-Up Studies, medicine.drug
الوصف: Introduction We previously reported an interim analysis of the DADI (dasatinib discontinuation) trial. The results showed that 48% of patients with chronic myeloid leukemia in the chronic phase who maintained a deep molecular response (DMR) for ≥ 1 year could discontinue second- or subsequent-line dasatinib treatment safely at a median follow-up of 20 months. However, the results from longer follow-up periods would be much more useful from a clinical perspective. Patients and Methods The DADI trial was a prospective, multicenter trial conducted in Japan. After confirming a stable DMR for ≥ 1 year, dasatinib treatment subsequent to imatinib or nilotinib was discontinued. After discontinuation, the loss of DMR (even of 1 point) was defined as stringent molecular relapse, thereby triggering therapy resumption. The predictive factors of treatment-free remission (TFR) were analyzed. Results The median follow-up period was 44.0 months (interquartile range, 40.5-48.0 months). The estimated overall TFR rate at 36 months was 44.4% (95% confidence interval, 32.0%-56.2%). Only 2 patients developed a molecular relapse after the 1-year cutoff point. The presence of imatinib resistance was a significant risk factor for molecular relapse. Moreover, high natural killer cell and low γδ+ T-cell and CD4+ regulatory T-cell (CD25+CD127low) counts before discontinuation correlated significantly with successful therapy discontinuation. Conclusion These findings suggest that discontinuation of second- or subsequent-line dasatinib after a sustained DMR of ≥ 1 year is feasible, especially for patients with no history of imatinib resistance. In addition, the natural killer cell count was associated with the TFR.
تدمد: 2152-2650
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e081aedcd3b2e8aaae79922bed4f899e
https://doi.org/10.1016/j.clml.2018.03.004
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....e081aedcd3b2e8aaae79922bed4f899e
قاعدة البيانات: OpenAIRE
الوصف
تدمد:21522650