{"id":26607,"date":"2020-12-15T12:00:00","date_gmt":"2020-12-15T12:00:00","guid":{"rendered":"https:\/\/www.cancer.gov\/news-events\/cancer-currents-blog\/2020\/cml-stopping-tki-treatment-improves-quality-of-life"},"modified":"2024-11-03T15:15:51","modified_gmt":"2024-11-03T15:15:51","slug":"stopping-tki-treatment-is-safe-improves-quality-of-life-for-some-with-cml","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/stopping-tki-treatment-is-safe-improves-quality-of-life-for-some-with-cml\/","title":{"rendered":"Stopping TKI Treatment Is Safe, Improves Quality of Life for Some with CML"},"content":{"rendered":"

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Drugs called TKIs are extremely effective in people with chronic myelogenous leukemia (CML), but can also cause side effects, including fatigue and depression.<\/p>\n

Credit: iStock<\/p>\n<\/div>\n<\/figcaption><\/figure>\n<\/div>\n

For many people with chronic myelogenous leukemia (CML), the drug imatinib (Gleevec)<\/a> changed a once-fatal blood cancer into a manageable disease and allowed them to live a nearly normal lifespan.<\/p>\n

Until recently, imatinib and related drugs for CML, known as tyrosine kinase inhibitors<\/a> (TKIs), had to be taken every day for life, and the drugs can cause fatigue, depression, disrupted sleep, diarrhea, and other side effects.<\/p>\n

In 2018, based on results of two international studies, the Food and Drug Administration (FDA) approved an update to the recommended use of the TKI nilotinib (Tasigna) for CML<\/a>. The update states that some people with CML who have been in remission<\/a> for at least 3 years on nilotinib can safely stop taking the drug, although they must be closely monitored to make sure the cancer has not come back, or recurred.<\/p>\n

New results from a US clinical study<\/a> confirm these findings for nilotinib as well as for imatinib and two other TKIs. The study is also the first to show that patients\u2019 quality of life improves after they stop TKI treatment<\/a>. About two-thirds of patients in the study remained in remission from CML 3 years after stopping treatment and most of them were still in remission at the 4-year mark. Many reported improvements in common treatment-related symptoms, particularly fatigue and diarrhea.<\/p>\n

\u201cWe had assumed that people with CML would feel better if they stopped treatment. Now we have hard data to back that up,\u201d said Kendra Sweet, M.D., of the Moffitt Cancer Center and Research Institute, who was not an investigator on the new study but enrolled some patients on it.<\/p>\n

\u201cFor CML patients who are in a sustained deep remission\u2014with very low levels of leukemia cells in the blood for at least 2 years\u2014it\u2019s safe to stop treatment, and doctors should encourage their patients\u201d to try stopping, said Ehab Atallah, M.D., of the Medical College of Wisconsin, who led the study.<\/p>\n

The results, published November 12 in JAMA Oncology<\/em>, could help motivate people newly diagnosed with CML to take their medication daily as prescribed, with the hope that they might safely stop taking the drugs entirely down the line, Dr. Sweet said. <\/p>\n

Life After Stopping TKIs<\/h2>\n

The Life After Stopping TKIs (LAST) study enrolled 172 adults with CML from 14 university medical centers and cancer centers across the United States. Participants had CML that was well controlled with one of four TKIs used to treat the disease: imatinib, dasatinib (Sprycel)<\/a>, nilotinib, or bosutinib (Bosulif)<\/a>.<\/p>\n

To be included in the study, patients had to have been taking a TKI for at least 3 years and to have stayed in a deep molecular response for at least 2 years, meaning that their test results showed almost no cells in the blood containing the genetic alteration<\/a> that causes CML. <\/p>\n