Stopping second-generation TKIs in CML

Abstract

In this issue of Blood, Rea et al1 show that rigorously defined suboptimal response or resistance by European LeukemiaNet (ELN) criteria2 to first-line treatment with dasatinib or nilotinib (second-generation tyrosine kinase inhibitor [2G-TKIs]), or later in imatinib-intolerant patients, is a major negative predictor for the successful discontinuation of TKI therapy in chronic phase chronic myeloid leukemia (CML) patients who achieve deep sustained molecular responses. This result from an interim analysis of 60 patients in the observational STOP 2G-TKI study is an important contribution to the still evolving patient selection criteria for attempting to achieve a treatment-free remission (TFR) in clinical practice.3