Timothy Devos1, Gregor Verhoef2, Eva Steel3, Dominiek Mazure3, Philippe Lewalle4, Dominique Bron4, Zwi Berneman5, Fleur Samantha Benghiat6, Philippe Mineur7, Koen Theunissen8, Pierre Zachée9, Chantal Doyen10, Natalie Put11, Marie Lejeune12, Koen Van Eygen13, Violaine Havelange14, Michael Reusens15, Wim Pluymers15, Karen Peeters15. 1. Hematology Department, University Hospitals Leuven, Leuven, Belgium, fabienne.jordens@novartis.com. 2. Hematology Department, University Hospitals Leuven, Leuven, Belgium. 3. Universitair Ziekenhuis Ghent, Ghent, Belgium. 4. Institut Jules Bordet, Brussels, Belgium. 5. Universitair Ziekenhuis Antwerpen, Edegem, Belgium. 6. Hôpital Erasme, Brussels, Belgium. 7. Grand Hôpital de Charleroi (GHdC), Charleroi, Belgium. 8. Jessa Ziekenhuis, Campus Virga Jesse, Hasselt, Belgium. 9. Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp, Belgium. 10. Centre Hospitalier Universitaire UCL Namur, Yvoir, Belgium. 11. Ziekenhuis Oost-Limburg, Campus Sint-Jan, Genk, Belgium. 12. Centre Hospitalier Universitaire de Liège, Liège, Belgium. 13. AZ Groeninge, Campus Kennedylaan, Kortrijk, Belgium. 14. UCL Saint-Luc, Woluwe-Saint-Lambert, Belgium. 15. Novartis Pharma NV/SA, Vilvoorde, Belgium.
Abstract
OBJECTIVES: To assess interruptions/discontinuations of tyrosine kinase inhibitor (TKI) treatment in Belgian patients with chronic myeloid leukaemia (CML). METHODS: This retrospective study included patients with TKI interruptions/discontinuations of ≥4 continuous weeks (no clinical trial context) between May 2013 and May 2016. Data collection took place between October 2016 and February 2017. RESULTS: All 60 participants (69 interruptions/discontinuations) had chronic-phase CML and 75% had at least a major molecular response (≥MMR) at interruption/discontinuation. Most interruptions/discontinuations occurred while on imatinib (36/69; 49%) and dasatinib (20/69; 29%). Most interruptions/discontinuations occurred due to side effects/intolerance (46/69; 67%); other reasons included a wish to conceive (6/69; 9%) and attempts to achieve treatment-free remission (TFR) (6/69; 9%). Interruptions due to side effects occurred later for imatinib- or dasatinib-treated patients than for those on nilotinib or ponatinib. Treatment was re-initiated in 62% (43/69) of cases. Most interruptions caused by side effects/intolerance were followed by treatment changes. All 4 patients with ≥MR 4.5 at interruption/discontinuation and ≥11-month follow-up who had not restarted treatment maintained the response. CONCLUSION: Although TKIs are used for long-term CML treatment, physicians sometimes recommend interruptions/discontinuations. In this study, interruptions/discontinuations were mainly caused by side effects or intolerance, rather than TFR attempts.
OBJECTIVES: To assess interruptions/discontinuations of tyrosine kinase inhibitor (TKI) treatment in Belgian patients with chronic myeloid leukaemia (CML). METHODS: This retrospective study included patients with TKI interruptions/discontinuations of ≥4 continuous weeks (no clinical trial context) between May 2013 and May 2016. Data collection took place between October 2016 and February 2017. RESULTS: All 60 participants (69 interruptions/discontinuations) had chronic-phase CML and 75% had at least a major molecular response (≥MMR) at interruption/discontinuation. Most interruptions/discontinuations occurred while on imatinib (36/69; 49%) and dasatinib (20/69; 29%). Most interruptions/discontinuations occurred due to side effects/intolerance (46/69; 67%); other reasons included a wish to conceive (6/69; 9%) and attempts to achieve treatment-free remission (TFR) (6/69; 9%). Interruptions due to side effects occurred later for imatinib- or dasatinib-treated patients than for those on nilotinib or ponatinib. Treatment was re-initiated in 62% (43/69) of cases. Most interruptions caused by side effects/intolerance were followed by treatment changes. All 4 patients with ≥MR 4.5 at interruption/discontinuation and ≥11-month follow-up who had not restarted treatment maintained the response. CONCLUSION: Although TKIs are used for long-term CML treatment, physicians sometimes recommend interruptions/discontinuations. In this study, interruptions/discontinuations were mainly caused by side effects or intolerance, rather than TFR attempts.