A new study suggests that, if US patients with chronic myeloid leukemia (CML) discontinue tyrosine kinase inhibitor (TKI) treatment when eligible, more than $54 billion could be saved over the next 30 years. These findings were published in JAMA Network Open. For this study, researchers developed a microsimulation model that accounted for current and estimated new cases of CML in the United States. The researchers created the current (prevalent) cohort based on the population of patients with CML in 2018 using estimates from the SEER*Explorer website. Related Content The team created the coho ..read more

Among US patients with Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML), those with lower incomes have not derived the same benefits from therapeutic advances as those with higher incomes, according to a study published in Cancer. The study suggests that, overall, US patients with Ph+ CML have seen substantial improvements in overall survival (OS) since the emergence of BCR::ABL1 tyrosine kinase inhibitors (TKIs). However, OS improvements are less evident in patients with lower incomes. This is a disparity that is not observed in countries with universal insurance, research ..read more

Patients with chronic myeloid leukemia (CML) who receive nilotinib instead of other tyrosine kinase inhibitors (TKIs) may have a greater risk of developing diabetes and hyperlipidemia, according to research published in The Oncologist. Nilotinib was also associated with an increased risk of cardiovascular disease in certain patients, researchers found. This retrospective study included 1538 patients with CML treated with TKIs. The researchers calculated the incidence of diabetes, hyperlipidemia, hypertension, and cardiovascular disease across treatment groups. Among patients who did not have ..read more

Disease outcomes for patients with chronic myeloid leukemia (CML) have improved since the introduction of tyrosine kinase inhibitors (TKIs).1 However, the teratogenicity of these agents poses considerable challenges for patients who are pregnant when diagnosed with CML and for CML patients who conceive or wish to become pregnant while receiving TKI therapy. In a review published in April 2023 in Current Hematologic Malignancy Reports, Ellin Berman, MD, a hematologic oncologist at Memorial Sloan Kettering Cancer Center in New York, noted the dearth of guidelines regarding treatment strategies ..read more

The anti-emetic agent metoclopramide blocked CD93 signaling in cell culture and delayed leukemia development in mice, according to data from a preclinical study published in Cell Reports. The results indicate that CD93 signaling, which is an important regulator of self-renewal and proliferation of murine and human leukemia stem cells (LSCs), could be a potential therapeutic target for the elimination of LSCs in chronic myeloid leukemia (CML). To characterize the function of CD93 in CML, the researchers first demonstrated that all subsets of LSCs expressed CD93 while more differentiated leukem ..read more

The Food and Drug Administration (FDA) has approved the supplemental New Drug Application (sNDA) for Iclusig® (ponatinib; Takeda) for adults with chronic-phase (CP) chronic myeloid leukemia (CML) with resistance or intolerance to at least 2 prior kinase inhibitors. The sNDA approval is based on efficacy and safety data from the open-label phase 2 OPTIC trial and 5-year data from the phase 2 PACE trial. The OPTIC trial included 282 adults with CP-CML whose disease was considered to be resistant or resistant/intolerant to at least 2 prior kinase inhibitors or who had the T315I mutation. The PAC ..read more

Most patients with chronic myelogenous leukemia (CML) are being prescribed costly second-generation tyrosine kinase inhibitors (TKIs), even though generic imatinib has been available since 2016, found a recent study in JAMA Oncology. The study included patients with a CML diagnosis who initiated treatment with a TKI between January 1, 2010, and December 31, 2019, and were identified using the database OptumLabs Data Warehouse. Medical and pharmacy claims data were extracted from the database for patients with commercial insurance and Medicare Advantage. For their first year of TKI treatment ..read more

Patients with chronic myeloid leukemia in chronic phase (CML-CP) who do not respond to first-line imatinib may benefit from early monitoring in order to switch to treatment with dasatinib, according to the results of the phase 2b DASCERN study. About 1 in 3 patients treated with first-line imatinib will not achieve early molecular response, lowering their chances of achieving deep molecular response. The DASCERN trial was designed to see if an early switch to dasatinib in those patients with suboptimal response to imatinib would improve response rates. The study randomly assigned treatment to ..read more

Baseline kinetics of breakpoint cluster region (BCR)-ABL proto-oncogene 1 (ABL1) and decline over time in patients with chronic myeloid leukemia (CML) was associated with long-term remission status. These findings were published in the journal Blood. Long-term treatment-free remission (TFR) is becoming the goal of therapy for patients with CML, and to achieve this, strategies that sustain TFR are needed. Therefore, researchers conducted this study to identify key determinants of sustained treatment-free remission. Researchers identified 115 patients who were in treatment-free remission from C ..read more

The use of tyrosine kinase inhibitor (TKI) therapy may provide a degree of protection against COVID-19 in patients with chronic myeloid leukemia (CML). These findings are suggested by in a case report and literature review published in the European Journal of Case Reports in Internal Medicine. The case report involved a 42-year-old man treated for chronic phase CML with dasatinib who had achieved major molecular response in October 2020. In December 2020, he developed COVID-19, for which he was seen at an emergency department. His white blood cell count was 4.4×103/mm3, hemoglobin level was 1 ..read more