Tyrosine kinase inhibitor (TKI) treatment of chronic myeloid leukemia (CML) can result in prolonged and deep responses in many patients. In such cases, can TKIs be safely discontinued to avoid adverse side effects and costs? Etab Atallah (Medical College of Wisconsin, USA) discusses the current issues surrounding TKI discontinuation in CML.

They add: “Further studies should explore whether activated SRC is a prognostic biomarker of more indolent disease or is a predictive biomarker of response to tyrosine kinase therapy.”

Advisory Board Member Xavier Thomas discusses the potential of FLT3 inhibitors for the treatment of acute myeloid leukemia.

Study findings suggest that bosutinib could be considered as an alternative to imatinib for first-line tyrosine kinase inhibitor therapy in patients with newly diagnosed chronic myeloid leukemia in the chronic phase.

Study findings suggest that the depth of molecular response to imatinib achieved by a patient with chronic myeloid leukemia may influence the relationship between a fluctuating response to treatment and the likelihood of developing resistance to the tyrosine kinase inhibitor.

Patients with gastrointestinal stromal tumors harboring KIT proto-oncogene receptor tyrosine kinase exon 11 deletion mutations derive the greatest benefit from 3 years of adjuvant imatinib treatment, researchers report.

Primary kinetic responses to the tyrosine kinase inhibitor imatinib do not differ significantly between children and adults with chronic myeloid leukemia, German study data show.

The phase III International Randomized Study of Interferon and STI571 (IRIS) randomly assigned 1106 patients with newly diagnosed CML in the chronic phase to receive either the tyrosine kinase inhibitor imatinib (n=553) or interferon alfa plus cytarabine (n=553).

Findings from the chronic myeloid leukemia IV study suggest that patients in the chronic phase who respond to imatinib have a high likelihood of survival at 10 years.

Chronic myeloid leukemia patients with high CD62L T-cell expression and low soluble CD62L plasma levels at diagnosis have the best chance of achieving a deep molecular response to first-line therapy with tyrosine kinase inhibitors, study findings indicate.

This highlights “the importance of frequent monitoring of patients who stop [tyrosine kinase inhibitor] therapy to ensure timely retreatment,” say Andreas Hochhaus (Universitä̈tsklinikum Jena, Germany) and co-authors of the study.

The majority (61%) had received three or more tyrosine kinase inhibitors previously.

For patients undergoing front-line treatment for chronic myeloid leukemia, generic treatment may be less effective than the branded agent, researchers suggest, but treatment efficacy is maintained in patients who switch from a branded to a generic formulation.

Among 30 CML patients who had received a tyrosine kinase inhibitor for at least 1 month – nilotinib in five patients, imatinib in seven, and dasatinib in 18 – 10 had a positive fecal occult blood test.