Outcomes of the EURO-SKI Trial and the British DESTINY Study Reported ASH Meeting in San Diego Show that Reducing or Stopping a TKI Can Be Safe and Beneficial for Some Patients with CML

Outcomes of the EURO-SKI Trial and the British DESTINY Study reported at the 58th Annual Meeting of the American Society of Haematology, December 3 – 6.  Prof.Mhairi Copland, MD, PhD, of the University of Glasgow, UK, set out to study a cohort of patients with CML from the British DESTINY Study who decreased their dose of tyrosine kinase inhibitor. Prof.Copland and colleagues found that many patients with CML may be able to safely reduce side effects of tyrosine kinase inhibition by cutting their dose in half. 

In contrast to other trials, which have focused on patients nearly free of leukaemia, the DESTINY Study included patients with a stable molecular remission level demarcated as molecular response 3, “good, but not perfect,” said Professor Copland. The results suggest that a wider range of patients may be able to safely reduce tyrosine kinase inhibition than previously thought.
Of 174 study participants, the vast majority (93%) showed no evidence of leukemia rebound 1 year after cutting their dose of tyrosine kinase inhibitor. Many reported a significant decrease in associated side effects within the first 3 months. Twelve participants showed signs of leukaemia recurrence, all of whom regained a remission level of molecular response 3 or better, within 4 months of resuming a full dose.

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