Stopping dasatinib treatment in patients with chronic myeloid leukemia and stable deep molecular response

This study aimed to investigate treatment-free remission after dasatinib treatment in patients with chronic-phase chronic myeloid leukemia.  

This study concluded that it is possible to stop dasatinib treatment in these patients once they have achieved a deep molecular response.  

Dasatinib (Sprycel) is a targeted therapy called a tyrosine kinase inhibitor (TKI). It is used to treat chronic myelogenous leukemia (CML) and acute lymphoblastic leukemia (ALL). Deep molecular response (DMR) is achieved when no BCR-ABL genes are detected. BCR-ABL genes are found in cancerous cells. When deep molecular response (DMR) is achieved by patients they are considered to be in remission. 

Treatment-free remission (TFR) in patients with chronic phase CML (CP-CML) is now considered an option, as TKIs like dasatinib can induce higher rates of sustained DMR. It was not known if ending dasatinib treatment and allowing TFR would be safe and effective for patients with CP-CML.  

This study involved 84 patients with CP-CML who ended dasatinib treatment. TFR in these patients was monitored.  

After 2 years, TFR for all patients was 46%. There were significant associations between 2-year TFR and duration of prior dasatinib, line of therapy and age. A total of 46 patients (55%) lost molecular response. They were restarted on dasatinib and 44 (98%) regained molecular response on an average of 2 months.

After 2 years, 99% of all patients din not have disease progression. No disease transformation occurred. 11% of all patients experienced dasatinib withdrawal symptoms. These included muscle symptoms and high blood pressure.  

This study concluded that it is possible to discontinue dasatinib treatment in patients with CP-CML once they have achieved a deep molecular response. 

This study was based on medical records. Some data might have been missing. This study was funded by Bristol-Myers Squibb, the manufacturer of dasatinib.