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Giles FJ, Masszi T, Gómez Casares MT, Hellmann A, Stentoft J, Conneally E, García Gutierrez V, Gattermann N, Le Coutre PD, Martino B, Saussele S, Radich JP, Ross DM, Saglio G, Sondhi M, Acharyya S, Aimone P, Hochhaus A. Treatment-free remission (TFR) following frontline (1L) nilotinib (NIL) in patients (pts) with chronic myeloid leukemia in chronic phase (CML-CP): 192-week data from the ENESTfreedom study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.7013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7013 Background: In ENESTfreedom (NCT01784068), which evaluated TFR following 1L NIL in CML-CP pts, 51.6% remained in TFR 48 wks after stopping treatment (primary endpoint) and durability of TFR was demonstrated at 144 wks. Data from longer follow-up (192 wks) evaluating maintenance of TFR are reported. Methods: Pts with MR4.5 ( BCR-ABL1IS ≤0.0032%) and ≥2y of 1L NIL entered a 1y consolidation; pts with sustained deep molecular response (MR) were eligible for TFR. NIL was resumed after loss of major MR (MMR; BCR-ABL1IS ≤0.1%). At the latest data cut-off (Sep 17 2018), all pts had completed ≥192 wks of TFR, resumed NIL, or discontinued the study. Results: By the data cut-off, of 190 pts entering TFR, 87 were ongoing, 91 had resumed NIL, and 12 had permanently discontinued. The TFR rate at 192 wks was 44.2% (84/190, 95% CI: 37.0–51.6%). Of 89 pts with successful TFR at 144 wks, 5 were not assessable for TFR at 192 wks as 2 had discontinued by 192 wks due to pt/physician decision, and 3 with MR4.5 previously did not have 192 wk PCR data. Of 91 pts who resumed NIL, 90 (98.9%) regained MMR and 84 (92.3%) regained MR4.5. 75/90 and 73/84 pts, respectively, had stable MMR and MR4.5 at 48 wks later. There were no cases of disease progression or new deaths. 10 deaths were reported in the 144-wk analysis, none due to CML. The 192-wk treatment-free survival rate was 48.7% (95% CI 41.4–55.6%). Of 89 pts remaining in TFR for > 144 wks (including 87 pts for > 192 wks), all-grade AE rates during consolidation and each subsequent 48 wk period of TFR were 84.3%, 77.5%, 70.8%, 48.3%, and 52.8%, respectively. All-grade musculoskeletal pain AE rates were 15.7%, 40.4%, 9.0%, 3.4% and 3.4%, respectively; cardiovascular event rates were low across these periods. Among pts who resumed NIL, most common AEs were nasopharyngitis (18.7%) and pruritus, fatigue, and increased lipase (14.3% each); the majority of AEs were grade 1/2. Conclusions: Results continue to support the long-term durability and safety of TFR at 192 wks after stopping 1L NIL; overall AE rates declined during the TFR phase and musculoskeletal pain AEs were transient. Pts should continue to be regularly monitored during TFR. Clinical trial information: NCT01784068.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Bruno Martino
- Azienda Ospedaliera Bianchi Melacrino Morelli, Reggio Calabria, Italy
| | - Susanne Saussele
- III. Med. Klinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Jerald P. Radich
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | | | - Manu Sondhi
- Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | | | | | - Andreas Hochhaus
- Abteilung Hämatologie/Onkologie, Universitätsklinikum Jena, Jena, Germany
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Radich JP, Masszi T, Gómez Casares MT, Hellmann A, Stentoft J, Conneally E, García Gutierrez V, Gattermann N, Le Coutre PD, Martino B, Saussele S, Giles FJ, Ross DM, Saglio G, Sondhi M, Acharyya S, Chaturvedi S, Bédoucha V, Hochhaus A. Long-term treatment-free remission (TFR) following frontline (1L) nilotinib in patients (pts) with chronic myeloid leukemia in chronic phase (CML-CP): ENESTfreedom 144-wk results. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.7063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jerald P. Radich
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | | | | | | | | | | | | | | | - Bruno Martino
- Azienda Ospedaliera Bianchi Melacrino Morelli, Reggio Calabria, Italy
| | - Susanne Saussele
- III. Med. Klinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | | | | | | | - Manu Sondhi
- Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | | | | | | | - Andreas Hochhaus
- Abteilung Hämatologie/Onkologie, Universitätsklinikum Jena, Jena, Germany
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Kreitman RJ, Dearden C, Zinzani PL, Delgado J, Robak T, Le Coutre PD, Gjertsen BT, Troussard X, Saglio G, Roboz GJ, Karlin L, Gladstone DE, Balic K, Standifer N, He P, Marshall S, Wilson WH, Pastan I, Yao NS, Giles FJ. Moxetumomab pasudotox in heavily pretreated patients with relapsed/refractory hairy cell leukemia: Results of a pivotal international study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.7004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Tadeusz Robak
- Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland
| | | | - Bjorn T. Gjertsen
- Department of Internal Medicine, Hematology Section, Haukeland University Hospital, Bergen, Norway
| | | | | | - Gail J. Roboz
- New York-Presbyterian Weill Cornell Medical Center, New York, NY
| | | | | | | | | | | | | | | | - Ira Pastan
- National Cancer Institute, National Institutes of Health, Bethesda, MD
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Cortes JE, Mauro MJ, Deininger MW, Chuah C, Kim DW, Kota V, Lipton JH, Rousselot PH, Milojkovic D, Le Coutre PD, García Gutierrez V, Crescenzo RJ, Leip E, An F, Bouxin N, Hochhaus A, Brümmendorf TH, Gambacorti-Passerini C. Bosutinib vs imatinib for newly diagnosed chronic myeloid leukemia in the BFORE trial: 24-month follow-up. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.7002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jorge E. Cortes
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Charles Chuah
- Singapore General Hospital and Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Dong-Wook Kim
- Seoul St Mary’s Hospital, Leukemia Research Institute, The Catholic University of Korea, Seoul, Korea, Republic of (South)
| | - Vamsi Kota
- Winship Cancer Institute of Emory University, Atlanta, GA
| | | | - Philippe H. Rousselot
- Service d’Hématologie et Oncologie, Hôpital de Versailles, Université Versailles Saint Quentin en Yvelines, Le Chesnay, France
| | | | | | | | | | | | - Fiona An
- Multiple Myeloma Rsrch Fndtn, Norwalk, CT
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