Current event-free survival after sequential tyrosine kinase inhibitor therapy for chronic myeloid leukemia

Aref Al-Kali, Hagop Kantarjian, Jianqin Shan, Roland Bassett, Alfonso Quintás-Cardama, Gautam Borthakur, Elias Jabbour, Srdan Verstovsek, Susan O'Brien, Jorge Cortes

Research output: Contribution to journalArticle

Abstract

Background: Imatinib is an effective tyrosine kinase inhibitor (TKI) for patients with chronic myeloid leukemia (CML) in chronic phase (CP). Although some patients may fail on therapy with imatinib, effective salvage therapy is available with second-generation TKIs. Current measurement of efficacy for each therapy is judged by its individual impact on overall survival and event-free survival (EFS). Methods: In total, 586 patients with CML in CP who received imatinib were included in this analysis in 2 cohorts: imatinib as front-line therapy (n = 281) or after failure on interferon-α (IFN-α) (n = 305). By accounting for successful salvage treatment (ie, regain of complete cytogenetic response), the current EFS (CEFS) rate was calculated to obtain a more accurate impression of the outcome of patients with CML who received treatment with sequential TKIs. Results: For patients who received imatinib after failing on IFN-α, the 7-year EFS rate was 61%, whereas the CEFS rate was 69%. The 7-year EFS rate for patients who received imatinib as initial therapy was 81% compared with a 7-year CEFS rate of 88%. Conclusions: CEFS provided a more accurate representation of the outcome of patients with CML in CP. These patients may frequently be treated successfully with subsequent TKIs after experiencing failure on the first TKI.

Original languageEnglish (US)
Pages (from-to)327-335
Number of pages9
JournalCancer
Volume117
Issue number2
DOIs
StatePublished - Jan 15 2011
Externally publishedYes

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Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Protein-Tyrosine Kinases
Disease-Free Survival
Leukemia, Myeloid, Chronic Phase
Salvage Therapy
Survival Rate
Therapeutics
Interferons
Cytogenetics
Imatinib Mesylate
Survival

Keywords

  • chronic myeloid leukemia
  • current event-free survival
  • event-free survival
  • failure
  • interferon-α
  • tyrosine kinase inhibitor

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Al-Kali, A., Kantarjian, H., Shan, J., Bassett, R., Quintás-Cardama, A., Borthakur, G., ... Cortes, J. (2011). Current event-free survival after sequential tyrosine kinase inhibitor therapy for chronic myeloid leukemia. Cancer, 117(2), 327-335. https://doi.org/10.1002/cncr.25604

Current event-free survival after sequential tyrosine kinase inhibitor therapy for chronic myeloid leukemia. / Al-Kali, Aref; Kantarjian, Hagop; Shan, Jianqin; Bassett, Roland; Quintás-Cardama, Alfonso; Borthakur, Gautam; Jabbour, Elias; Verstovsek, Srdan; O'Brien, Susan; Cortes, Jorge.

In: Cancer, Vol. 117, No. 2, 15.01.2011, p. 327-335.

Research output: Contribution to journalArticle

Al-Kali, A, Kantarjian, H, Shan, J, Bassett, R, Quintás-Cardama, A, Borthakur, G, Jabbour, E, Verstovsek, S, O'Brien, S & Cortes, J 2011, 'Current event-free survival after sequential tyrosine kinase inhibitor therapy for chronic myeloid leukemia', Cancer, vol. 117, no. 2, pp. 327-335. https://doi.org/10.1002/cncr.25604
Al-Kali A, Kantarjian H, Shan J, Bassett R, Quintás-Cardama A, Borthakur G et al. Current event-free survival after sequential tyrosine kinase inhibitor therapy for chronic myeloid leukemia. Cancer. 2011 Jan 15;117(2):327-335. https://doi.org/10.1002/cncr.25604
Al-Kali, Aref ; Kantarjian, Hagop ; Shan, Jianqin ; Bassett, Roland ; Quintás-Cardama, Alfonso ; Borthakur, Gautam ; Jabbour, Elias ; Verstovsek, Srdan ; O'Brien, Susan ; Cortes, Jorge. / Current event-free survival after sequential tyrosine kinase inhibitor therapy for chronic myeloid leukemia. In: Cancer. 2011 ; Vol. 117, No. 2. pp. 327-335.
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abstract = "Background: Imatinib is an effective tyrosine kinase inhibitor (TKI) for patients with chronic myeloid leukemia (CML) in chronic phase (CP). Although some patients may fail on therapy with imatinib, effective salvage therapy is available with second-generation TKIs. Current measurement of efficacy for each therapy is judged by its individual impact on overall survival and event-free survival (EFS). Methods: In total, 586 patients with CML in CP who received imatinib were included in this analysis in 2 cohorts: imatinib as front-line therapy (n = 281) or after failure on interferon-α (IFN-α) (n = 305). By accounting for successful salvage treatment (ie, regain of complete cytogenetic response), the current EFS (CEFS) rate was calculated to obtain a more accurate impression of the outcome of patients with CML who received treatment with sequential TKIs. Results: For patients who received imatinib after failing on IFN-α, the 7-year EFS rate was 61{\%}, whereas the CEFS rate was 69{\%}. The 7-year EFS rate for patients who received imatinib as initial therapy was 81{\%} compared with a 7-year CEFS rate of 88{\%}. Conclusions: CEFS provided a more accurate representation of the outcome of patients with CML in CP. These patients may frequently be treated successfully with subsequent TKIs after experiencing failure on the first TKI.",
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