Is there a role for dose modification of TKI therapy in CML

Copland, M. (2019) Is there a role for dose modification of TKI therapy in CML. Current Hematologic Malignancy Reports, 14(4), pp. 337-345. (doi: 10.1007/s11899-019-00524-w) (PMID:31197525) (PMCID:PMC6647386)

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Abstract

Purpose of review: For patients with chronic phase chronic myeloid leukemia (CP-CML), there is an increasing focus on personalization of therapy with dose modifications of tyrosine kinase inhibitors (TKIs) to reduce side effects and maintain efficacy. Dose reductions are also being considered in clinical trials prior to treatment-free remission (TFR) attempts. Recent findings: Recent retrospective analyses of large clinical trials show that dose modification/reduction is safe. Efficacy is generally maintained and side effects are improved. Clinical trials such as DESTINY have demonstrated that dose reduction is safe for patients in deep molecular remission and may be considered prior to a TFR attempt. Summary: Dose modifications are widely used to prevent and manage the toxicities of TKIs. With adequate monitoring, dose optimization is safe, reduces side effects, and improves quality-of-life for patients. Clinical trials of dose optimization are currently recruiting across all approved TKIs and will lead to further personalization of therapy for CP-CML patients in the future.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Copland, Professor Mhairi
Authors: Copland, M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
Journal Name:Current Hematologic Malignancy Reports
Publisher:Springer
ISSN:1558-8211
ISSN (Online):1558-822X
Published Online:14 June 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in Current Hematologic Malignancy Reports 14(4):337-345
Publisher Policy:Reproduced under a Creative Commons License

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