Long-Term Efficacy of High-Dose Imatinib in Hispanic Patients Without Access to Second-Generation Tyrosine Kinase Inhibitors Treated in LATAM Centers.

Autor: Cantu-Rodriguez OG; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Servicio de Hematologia, Monterrey, Nuevo León, Mexico. Electronic address: ogcantur@yahoo.com.mx., Osorno-Rodriguez KL; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Servicio de Hematologia, Monterrey, Nuevo León, Mexico., Dorsey-Trevino EG; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Servicio de Hematologia, Monterrey, Nuevo León, Mexico., Gutierrez-Aguirre CH; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Servicio de Hematologia, Monterrey, Nuevo León, Mexico., Jaime-Perez JC; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Servicio de Hematologia, Monterrey, Nuevo León, Mexico., Gomez-Villarreal JP; Instituto Mexicano del Seguro Social, Servicio de Hematologia, UMAE 25, Monterrey, Nuevo Leon, Mexico., Rios-Rodelo MR; Instituto Mexicano del Seguro Social, Servicio de Hematologia, UMAE 25, Monterrey, Nuevo Leon, Mexico., Gonzalez-Cantu GA; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Servicio de Hematologia, Monterrey, Nuevo León, Mexico., Contreras-Arce A; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Servicio de Hematologia, Monterrey, Nuevo León, Mexico., Colunga-Pedraza PR; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Servicio de Hematologia, Monterrey, Nuevo León, Mexico., Gomez-De Leon A; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Servicio de Hematologia, Monterrey, Nuevo León, Mexico., Mancias-Guerra MDC; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Servicio de Hematologia, Monterrey, Nuevo León, Mexico., Tarin-Arzaga LDC; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Servicio de Hematologia, Monterrey, Nuevo León, Mexico., Gomez-Almaguer D; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Servicio de Hematologia, Monterrey, Nuevo León, Mexico.
Jazyk: angličtina
Zdroj: Clinical lymphoma, myeloma & leukemia [Clin Lymphoma Myeloma Leuk] 2023 Nov; Vol. 23 (11), pp. e386-e392. Date of Electronic Publication: 2023 Aug 08.
DOI: 10.1016/j.clml.2023.08.004
Abstrakt: Background: While second-generation tyrosine kinase inhibitors (TKI) revolutionized treatment for patients with chronic myeloid leukemia (CML) who developed a suboptimal response to imatinib, many patients in developing countries are fixed to the latter due to socioeconomic barriers. Despite this scenario, scarce information is available to evaluate the clinical prognosis of these patients.
Methods: We conducted a retrospective cohort analysis to compare the overall mortality of patients with CML who developed a suboptimal response to a standard dose of imatinib and were treated with either high-dose imatinib or a second-generation TKI. We created a marginal structural model with inverse probability weighting and stabilized weights. Our primary outcome was overall survival (OS) at 150 months. Our secondary outcomes were disease-free survival (DFS) at 150 months and adverse events.
Results: The cohort included 148 patients, of which 32 received high-dose imatinib and 116 a second-generation TKI. No difference was found in the 150-month overall survival risk (RR: 95% CI 0.91, 0.55-1.95, P-value = .77; RD: -0.04, -0.3 to 0.21, P-value = .78) and disease-free survival (RR: 1.02, 95% CI 0.53-2.71, P-value = .96; RD: 0.01, -0.26 to 0.22, P-value = .96). There was also no difference in the incidence of adverse events in either group.
Conclusion: Ideally, patients who develop a suboptimal response to imatinib should be switched to a second-generation TKI. If impossible, however, our findings suggest that patients treated with high-dose imatinib have a similar overall survival and disease-free survival prognosis to patients receiving a second-generation TKI.
Competing Interests: Disclosure David Gomez-Almaguer receives compensation for national lectures from Abbvie, Bristol Myers Squibb, Janssen, AMGEN, and Roche; compensation for participation in the advisory board from Abbvie, Bristol Myers Squibb, Janssen, AMGEN, and Roche. Andres Gomez-De Leon receives compensation for national lectures from Abbvie and BMS; compensation for participation in advisory Board from Abbvie and BMS. The rest of the authors declare no competing financial interests.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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