CML clinical

Asciminib monotherapy was well tolerated and showed promising clinical activity in pts with baseline BCR-ABL1IS ≤ 1%, with 75.0% remaining on therapy and in MMR at the data cutoff. These results support further investigation of asciminib in pts who did not reach an optimal treatment outcome and discontinued TKIs.  
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Katerina Machova Polakova, Adela Benesova, Margherita Martelli, et al.
 
The authors of the abstract conclude: 

Our data suggest that loss of DMR followed by BCR-ABL1 increase to the level of MMR is an early indicator for NGS mutation testing. In contrast, the probability of mutation detection in pts who do not achieve better response than unstable MMR seems to be low. MMR is the level of measurable residual disease above which NGS of BCR-ABL1 can successfully be performed. However, mutation testing in MMR samples should be done in duplicate and results should be evaluated carefully. It is unclear whether low-level variants detected only in one of the duplicates of the investigated sample can be artefacts that occur during processing of low-copy BCR-ABL1 samples. Hence, follow-up testing in subsequent samples should be performed to monitor mutation kinetics.

Support EUTOS2018, MZCR 00023736————————————————————————————————————————————————————————

 
Jorge Cortes, Elza Lomaia, Anna Turkina, et al.
 
The authors of the abstract conclude: 
Results from this OPTIC interim analysis show a trend toward dose-dependent efficacy and safety, and may provide a refined understanding of the ponatinib benefit:risk profile and its relation to dose. Mature data from continued follow-up may support an alternate dosing regimen for patients with CP-CML.
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Lydia ROY, Jean-Claude CHOMEL, Joelle GUILHOT, et al.
 
The authors of the abstract conclude: 
In conclusion, the study exhibits a manageable toxicity with the combination of DAS+Peg-IFN as starting therapy for CML. A high rate of early and sustained DMR was achieved, leading these patients as potential candidates for further TKI discontinuation attempt. 
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Hjalmar Flygt, Fredrik Sandin, Arta Dreimane, et al.
 
The authors of the abstract conclude: 
With a median follow-up of 9 years from diagnosis, TKI treatment was stopped in DMR in 24% of 548 evaluable CML patients, in a population-based setting. The majority stopped TKI outside clinical trials despite lack of recommendations in national guidelines at the time. Of those stopping TKI outside a study, the probability of remaining TKI treatment-free at 22 months was 61%. The reasons for higher TFR rate outside studies may be longer duration of therapy before stop and/or more frequent use of 2nd generation TKIs in this group.