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Saussele S, Gambacorti-Passerini C, García Gutierrez V, Abboud CN, Purcell S, Viqueira A, Leip E, Ernst T, Giles F, Hochhaus A. Bosutinib in patients with chronic phase chronic myeloid leukemia intolerant to prior tyrosine kinase inhibitors: Analyses from the BYOND study. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.7551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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
7551 Background: Bosutinib (BOS) is approved for patients (pts) with Philadelphia chromosome (Ph)+ chronic myeloid leukemia (CML) resistant/intolerant to prior therapy and in newly diagnosed pts in chronic phase (CP). Methods: The ongoing phase 4 BYOND study is further evaluating efficacy and safety of BOS (starting dose 500 mg/d) for CML resistant/intolerant to prior tyrosine kinase inhibitors (TKIs). We report findings in pts intolerant to all prior TKIs. Data are reported ≥1 y after the last enrolled pt (~85% TKI-intolerant pts had ≥2 y follow-up). Results: Of 163 pts who received BOS, 156 had Ph+ CP CML. 73 pts entered the study due to intolerance; 29, 26 and 18 had 1 (CP2L), 2 (CP3L) and 3 (CP4L) prior TKIs, respectively. After a median follow-up of 30.4 mo, median treatment duration across all 3 cohorts (CP2L, CP3L, CP4L, respectively) was 25.3 mo (29.2, 24.6, 17.6) and median dose intensity was 292.0 mg/d (304.5, 284.8, 272.1). Across CP CML cohorts (CP2L, CP3L, CP4L, respectively), 84.9% of patients (82.8%, 88.5%, 83.3%) had ≥1 dose reduction and 83.6% (79.3%, 84.6%, 88.9%) had ≥1 dose interruption due to adverse events (AEs). At the data cutoff, 53.4% (CP2L 65.5%, CP3L 42.3%, CP4L 50.0%) were still receiving BOS. The most common reason for discontinuation was AEs (28.8%). The most common ( > 40%) treatment-emergent AEs (TEAEs) were diarrhea (87.7%) and nausea (43.8%). Grade 3/4 TEAEs in > 10% of pts were diarrhea (16.4%), increased alanine aminotransferase (19.2%) and increased lipase (12.3%). Most pts with a valid baseline assessment achieved major molecular responses (MMR) across therapy lines (Table). Deaths occurred in 4 pts (CP2L 1, CP3L 3, CP4L 0); none were related to BOS or CML. Overall survival rate (95% CI) at 2 y in TKI-intolerant pts was 97.2% (89.2–99.3); rates were 96.4% (77.2–99.5), 96.0% (74.8–99.4) and 100% (100–100) in CP2L, CP3L and CP4L pts, respectively. Conclusions: A long duration of treatment and high response rate were observed in TKI-intolerant pts treated with BOS. Despite being intolerant to all prior therapies, ≥50% of pts in the overall intolerant cohort remained on BOS treatment at the data cutoff and > 80% achieved/maintained MMR. These results further support BOS use in pts with Ph+ CP CML and intolerance to all prior TKIs. Clinical trial information: NCT02228382 . [Table: see text]
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Affiliation(s)
- Susanne Saussele
- University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | | | | | | | | | | | | | | | - Frank Giles
- Developmental Therapeutics Consortium, Chicago, IL
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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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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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Gutierrez VG, Cortes J, Deininger M, Baer M, Kota V, Akard L, Chuah C, Guerci-Bresler A, Steegmann JL, Hernández Boluda JC, Lustgarten S, Haluska F, Farin H. The OPTIC Study: a Multi-Center, Randomized Phase 2 Trial with Response-Based Dose Reduction to Evaluate Three Starting Doses of Ponatinib. Clinical Lymphoma Myeloma and Leukemia 2016. [DOI: 10.1016/j.clml.2016.07.086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hochhaus A, Masszi T, Giles FJ, Radich JP, Ross DM, Gómez Casares MT, Hellmann A, Stentoft J, Conneally E, García Gutierrez V, Gattermann N, Wiktor-Jedrzejczak W, Le Coutre PD, Martino B, Saussele S, Menssen HD, Deng W, Krunic N, Bedoucha V, Saglio G. Treatment-free remission (TFR) in patients (pts) with chronic myeloid leukemia in chronic phase (CML-CP) treated with frontline nilotinib: Results from the ENESTFreedom study. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.7001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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)
| | - Tamas Masszi
- Fovarosi Onkormanyzat Szent Laszlo Korhaza, Hematologia, Budapest, Hungary
| | - Francis J. Giles
- Northwestern Medicine Developmental Therapeutics Institute, Chicago, IL
| | - Jerald P. Radich
- Seattle Cancer Care Alliance/Fred Hutchinson Cancer Research Center, Seattle, WA
| | - David M. Ross
- SA Pathology, Flinders Medical Centre, Adelaide, Australia
| | | | | | | | | | | | | | | | | | - Bruno Martino
- Azienda Ospedaliera Bianchi Melacrino Morelli, Reggio Calabria, Italy
| | - Susanne Saussele
- III. Med. Klinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | | | - Weiping Deng
- Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - Nancy Krunic
- Novartis Institute for Biomedical Research, Cambridge, MA
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