Long-Term Outcomes of Imatinib Treatment for Chronic Myeloid Leukemia.

Abstract

BACKGROUND:

Imatinib, a selective BCR-ABL1 kinase inhibitor, improved the prognosis for patients with chronic myeloid leukemia (CML). We conducted efficacy and safety analyses on the basis of more than 10 years of follow-up in patients with CML who were treated with imatinib as initial therapy.

METHODS:

In this open-label, multicenter trial with crossover design, we randomly assigned patients with newly diagnosed CML in the chronic phase to receive either imatinib or interferon alfa plus cytarabine. Long-term analyses included overall survival, response to treatment, and serious adverse events.

RESULTS:

The median follow-up was 10.9 years. Given the high rate of crossover among patients who had been randomly assigned to receive interferon alfa plus cytarabine (65.6%) and the short duration of therapy before crossover in these patients (median, 0.8 years), the current analyses focused on patients who had been randomly assigned to receive imatinib. Among the patients in the imatinib group, the estimated overall survival rate at 10 years was 83.3%. Approximately half the patients (48.3%) who had been randomly assigned to imatinib completed study treatment with imatinib, and 82.8% had a complete cytogenetic response. Serious adverse events that were considered by the investigators to be related to imatinib were uncommon and most frequently occurred during the first year of treatment.

CONCLUSIONS:

Almost 11 years of follow-up showed that the efficacy of imatinib persisted over time and that long-term administration of imatinib was not associated with unacceptable cumulative or late toxic effects. (Funded by Novartis Pharmaceuticals; IRIS ClinicalTrials.gov numbers, NCT00006343 and NCT00333840 .).

• Authors: Andreas Hochhaus, Richard A Larson, François Guilhot, Jerald P Radich, Susan Branford, Timothy P Hughes, Michele Baccarani, Michael W Deininger, Francisco Cervantes, Satoko Fujihara, Christine-Elke Ortmann, Hans D Menssen, Hagop Kantarjian, Stephen G O'Brien, Brian J Druker, IRIS Investigators
• Journal: The New England journal of medicine (N Engl J Med) Vol. 376 Issue 10 Pg. 917-927 (03 09 2017) ISSN: 1533-4406 [Electronic] United States
• PMID: 28273028 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Interferon-alpha
• Protein Kinase Inhibitors
• Cytarabine
• Imatinib Mesylate

Topics

• Adolescent
• Adult
• Aged
• Antineoplastic Agents (adverse effects, therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Cross-Over Studies
• Cytarabine (therapeutic use)
• Cytogenetic Analysis
• Female
• Follow-Up Studies
• Humans
• Imatinib Mesylate (adverse effects, therapeutic use)
• Intention to Treat Analysis
• Interferon-alpha (therapeutic use)
• Leukemia, Myelogenous, Chronic, BCR-ABL Positive (drug therapy, mortality)
• Male
• Middle Aged
• Protein Kinase Inhibitors (therapeutic use)
• Survival Analysis
• Young Adult