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Invited Commentary
November 12, 2020

Tyrosine Kinase Inhibitor Discontinuation in Patients With Chronic Myeloid Leukemia: Updates From the LAST Study on Patient-Reported Outcomes and Biomarkers for Relapse

Author Affiliations
  • 1Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland
JAMA Oncol. Published online November 12, 2020. doi:10.1001/jamaoncol.2020.5772

More than 20 years ago, the first patients were enrolled in the phase 1 trial of imatinib for treatment of chronic myeloid leukemia (CML).1 Inhibiting the kinase activity of the BCR-ABL1 fusion protein, the driving molecular abnormality of this disease, has rendered this once deadly leukemia a manageable condition. For patients with CML, a good disease outcome with nearly normal lifespan is expected, but treatment adverse effects remain a significant issue.2 While adverse effect profiles vary between drugs, many patients report decreased energy, diffuse pain, gastrointestinal upset, depressed mood, and additional adverse effects that are detrimental to their quality of life. Driven by a desire to decrease the burden of adverse effects, there has been extensive interest in whether some patients might safely discontinue treatment and experience long periods of treatment-free remission (TFR).

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