Chronic myeloid leukemia: incorporation of recent advances into current treatment algorithms - PubMed
4 hours ago
- #Chronic Myeloid Leukemia
- #Treatment Algorithms
- #Tyrosine Kinase Inhibitors
- Multiple BCR::ABL1 tyrosine kinase inhibitors (TKIs) and STAMP inhibitors are used for treating chronic myeloid leukemia in chronic phase (CML-CP).
- Treatment selection depends on factors like treatment goals, cost, CML risk, and patient comorbidities.
- Achieving a complete cytogenetic response (BCR::ABL1 <1% IS) within a year normalizes survival, while deeper molecular responses (<0.01% IS) may allow treatment discontinuation for treatment-free remission.
- Optimal biologic doses from post-approval studies are safer and as effective as approved standard doses.
- For TKI toxicities, dose reduction is preferred over switching unless toxicity is prohibitive, requiring a treatment change.
- Second- and third-line options after frontline therapy failure include second-generation TKIs, ponatinib, asciminib, and novel agents like olverembatinib, ELVN-001, TGRX-678, and TERN-701.
- The review discusses recent advances in CML-CP treatment and challenges established management practices.