The following article features coverage from the American Society of Hematology 2019 Annual Meeting. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

Treatment with tyrosine kinase inhibitor (TKI) significantly improves survival for patients with chronic myeloid leukemia (CML), but it is financially costly and is associated with a significant reduction in health-related quality of life (HRQOL). In the largest TKI discontinuation study in the United States to date, researchers provided a comprehensive evaluation of the molecular recurrence of CML and patient-reported outcomes after TKI discontinuation. The results were presented at the 61st American Society of Hematology (ASH) Annual Meeting & Exposition, held in Orlando, Florida.

The Life After Stopping TKIs (LAST) study included 172 patients with CML from 14 US cities between December 2014 and December 2016 who had received TKI therapy for at least 3 years. Patients were monitored for disease outcomes monthly for the first 6 months post discontinuation, then every 2 months until 24 months.

The researchers utilized a point system to rank patient outcomes. They hypothesized that on discontinuation TKI-associated symptoms should improve by 3 points. At 6 months post TKI discontinuation, the average estimated improvement in fatigue was 2.6 points; depression, 1.9 points; sleep disturbance, 0.9 points; and diarrhea, 2.7 points. Worsening of pain to the point where it affect daily life averaged 0.4 points. All patients reported improvements in depression, diarrhea, and fatigue. In general, approximately 17% of patients reported experiencing a clinically meaningful improvement in fatigue and/or diarrhea at 6 months.

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After 24 months, 107 (62%) patients remained in remission without treatment. “Our results provide important new evidence to support shared patient-provider clinical decision making,” wrote the study authors. They plan to perform a secondary analysis up to 3 years with an evaluation of additional patient-reported outcomes including anxiety, physical function, social function, and sexual function.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original abstract for a full list of disclosures.

Reference

Flynn KE, Weinfurt KP, Lin L, et al. Patient-reported outcome results from the U.S. Life After Stopping TKIs (LAST) Study in patients with chronic myeloid leukemia. Oral presentation at: 61st ASH Annual Meeting & Exposition; December 7-10, 2019; Orlando, FL. Abstract 705.