[CML] Comparison of response within 1 yr of Gleevec vs after 1 yr - From the ACOR Site

[Guest guest]

I have always questioned increasing the dose of Gleevec in order to get

a quicker response. This study seems to say that it doesn't matter.

Zavie

J Clin Oncol. 2006 Jan 20;24(3):454-9.

Comparison between patients with Philadelphia-positive chronic phase

chronic myeloid leukemia who obtained a complete cytogenetic response

within 1 year of imatinib therapy and those who achieved such a response

after 12 months of treatment.

Iacobucci I, Rosti G, Amabile M, Poerio A, Soverini S, Cilloni D,

Testoni N, Abruzzese E, Montefusco E, Ottaviani E, Iuliano F, Russo D,

Gobbi M, Alimena G, o B, Terragna C, Pane F, Saglio G, Baccarani

M, elli G.

Institute of Hematology and Medical Oncology " Seragnoli " , University of

Bologna, Bologna, Italy.

PURPOSE: Imatinib mesylate is a potent inhibitor of BCR-ABL, the

constitutively active tyrosine kinase protein critical for the

pathogenesis of chronic myeloid leukemia. PATIENTS AND METHODS: We

reviewed 284 patients with late chronic-phase Philadelphia chromosome

(Ph) -positive chronic myeloid leukemia treated with imatinib 400 mg

daily after interferon-alpha failure. In a retrospective study, we

evaluated the pattern and rapidity of the response to imatinib,

comparing the cytogenetic and molecular responses, progression-free and

overall survival rates in patients who obtained a complete cytogenetic

response within 1 year of treatment (early responders), and in patients

where a complete cytogenetic response was detected after 12 months (late

responders). RESULTS: After 3 or 4 years of treatment, the molecular

response of the late cytogenetic responders was similar to that of the

early cytogenetic responders. At 36 months of treatment the amount of

residual disease measured by standardized quantitative

reverse-transcriptase polymerase chain reaction was 0.00047 in late

responders versus 0.00022 in early responders, and at 48 months it was

0.00019 versus 0.00026 (median values, P value = nonsignificant). The

estimated 4-year progression-free survival rate was 88% for early

responders and 100% for late responders, while the estimated 4-year

overall survival rates were 92% and 100% for early and late responders,

respectively. CONCLUSION: The sensitivity and the response (cytogenic

and molecular) to imatinib may require 1 year or more. Long-term

follow-up results continue to improve in terms of rates and durability

of the complete cytogenetic response, major or complete molecular

response, and progression-free and overall survival.

Zavie (age 67)

67 Shoreham Avenue

Ottawa, Canada, dxd AUG/99

INF OCT/99 to FEB/00, CHF

No meds FEB/00 to JAN/01

Gleevec since MAR/27/01 (400 mg)

CCR SEP/01. #102 in Zero Club

PCRU 5/02 at RVH

2.8 log reduction Sep/05

e-mail: zmiller@...

Tel: 613-726-1117

Fax: 309-296-0807

Cell: 613-202-0204

ID: zaviem