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Dose Optimization of Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia: A New Therapeutic Challenge
| Content Provider | MDPI |
|---|---|
| Author | Iurlo, Alessandra Cattaneo, Daniele Bucelli, Cristina Breccia, Massimo |
| Copyright Year | 2021 |
| Description | The chronic myeloid leukemia (CML) therapeutic landscape has dramatically changed with tyrosine kinase inhibitor (TKI) development, which allows a near-normal life expectancy. However, long-term TKI exposure has been associated with persistent adverse events (AEs) which negatively impact on quality of life (QoL) and have the potential to cause significant morbidity and mortality. In clinical practice, TKI dose reduction is usually considered to reduce AEs and improve QoL, but dose optimization could have also another aim, i.e., the achievement and maintenance of cytogenetic and molecular responses. While therapy cessation appeared as a safe option for about half of the patients achieving an optimal response, no systematic assessment of long-term TKI dose de-escalation has been made. The present review is focused on the most recent evidences for TKIs dose modifications in CML clinical studies and in the real-life setting. It will consider TKI dose modifications in newly diagnosed patients, dose reduction for AEs, or in deep molecular response, either as a prelude to treatment-free remission (TFR) or as continuous maintenance therapy in those patients not wishing to attempt TFR. In addition, it will focus on patients not achieving a molecular response deep enough to go to TFR, and for whom dose reduction could be an option to avoid AEs. |
| Starting Page | 515 |
| e-ISSN | 20770383 |
| DOI | 10.3390/jcm10030515 |
| Journal | Journal of clinical medicine |
| Issue Number | 3 |
| Volume Number | 10 |
| Language | English |
| Publisher | MDPI |
| Publisher Date | 2021-02-01 |
| Access Restriction | Open |
| Subject Keyword | Journal of clinical medicine Journal of Clinical Medicine Oncology Chronic Myeloid Leukemia Tyrosine Kinase Inhibitor Imatinib Dasatinib Nilotinib Bosutinib Ponatinib Treatment De-escalation Treatment-free Remission Prognosis |
| Content Type | Text |
| Resource Type | Article |
