Current Strategies and Future Directions to Achieve Deep Molecular Response and Treatment-Free Remission in Chronic Myeloid Leukemia.

chronic myeloid leukemia deep molecular response optimal strategies treatment-free remission tyrosine kinase inhibitors

Journal

Frontiers in oncology
ISSN: 2234-943X
Titre abrégé: Front Oncol
Pays: Switzerland
ID NLM: 101568867

Informations de publication

Date de publication:
2020
Historique:
received: 07 01 2020
accepted: 05 05 2020
entrez: 26 6 2020
pubmed: 26 6 2020
medline: 26 6 2020
Statut: epublish

Résumé

The treatment of chronic myeloid leukemia (CML) has been radically changed by the approval of tyrosine kinase inhibitors (TKIs), which target BCR-ABL1 kinase activity. CML is now managed as a chronic disease requiring long-term treatment and close molecular monitoring. It has been shown that in a substantial number of patients who have achieved a stable deep molecular response (DMR), TKI treatment can be safely discontinued without loss of response. Therefore, treatment-free remission (TFR), through the achievement of a DMR, is increasingly regarded as a feasible treatment goal in many CML patients. However, only nilotinib has approval in this setting and a number of controversial aspects remain regarding treatment choices and timings, predictive factors, patient communication, and optimal strategies to achieve successful TFR. This narrative review aims to provide a comprehensive overview on how to optimize the path to DMR and TFR in patients with CML, and discusses recent data and future directions.

Identifiants

pubmed: 32582549
doi: 10.3389/fonc.2020.00883
pmc: PMC7280484
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

883

Informations de copyright

Copyright © 2020 Annunziata, Bonifacio, Breccia, Castagnetti, Gozzini, Iurlo, Pregno, Stagno and Specchia.

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Auteurs

Mario Annunziata (M)

Hematology Division, AORN Cardarelli-Napoli, Naples, Italy.

Massimiliano Bonifacio (M)

Section of Hematology, Department of Medicine, University of Verona, Verona, Italy.

Massimo Breccia (M)

Department of Translational and Precision Medicine, Sapienza University, Rome, Italy.

Fausto Castagnetti (F)

Department of Experimental, Diagnostic and Specialty Medicine, Institute of Hematology "L. and A. Seràgnoli", "S. Orsola-Malpighi" Univeristy Hospital, University of Bologna, Bologna, Italy.

Antonella Gozzini (A)

Department of Cellular Therapy and Transfusional Medicine, AUO Careggi, Florence, Italy.

Alessandra Iurlo (A)

Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Patrizia Pregno (P)

Hematology Division, Oncology and Hematology Department, AOU Città della Salute e della Scienza di Torino, Turin, Italy.

Fabio Stagno (F)

Division of Hematology and Bone Marrow Transplant, AOU Policlinico-V. Emanuele, Catania, Italy.

Giorgina Specchia (G)

Hematology Section, Department of Emergency and Organ Transplantation, University of Bari-Aldo Moro, Bari, Italy.

Classifications MeSH