Stopping tyrosine kinase inhibitors (TKIs) among patients with chronic myeloid leukemia (CML) is safe, and patients remain in treatment-free remission (TFR) with improved patient-reported outcomes (PROs; JAMA Oncol. 2020;e205774. doi:10.1001/jamaoncol.2020.5774).
TKIs are successful in improving CML patient survival but are also associated with severe adverse effects. Therefore, researchers performed a prospective single-group non-randomized clinical trial. The objective of the trial was “to evaluate molecular recurrence (MRec) and patient-reported outcomes (PROs) after TKI discontinuation for US patients with CML,” according to Ehab Atallah, MD, Department of Medicine, Medical College of Wisconsin (Milwaukee, WI) and colleagues.
The Life After Stopping TKIs (LAST) study enrolled 172 patients with CML from December 18, 2014 to December 12, 2016, with a minimum follow-up of 3 years. Each participant’s disease was well controlled with TKIs. Molecular recurrence and PROs were monitored.
A total of 171 patients were evaluable for molecular analysis. Of these, 65.5% remained in major molecular response and 60.8% achieved TFR. Of the TFR patients, improvements in patient outcomes were reported. Fatigue was improved in 80.4%, depression improved in 34.8%, diarrhea improved in 87.5%, sleep improved in 21.4%, and pain improved in 4.5% patients.
“In this study, TKI discontinuation was safe, and 60.8% of patients remained in TFR,” concluded Dr Atallah and colleagues. “Discontinuation of TKIs was associated with improvements in PROs. These findings should assist patients and physicians in their decision-making regarding discontinuation of TKIs.”—Lisa Kuhns
