Some leukemia patients may be able to safely stop treatment

October 21, 2010 by Lin Edwards report
Package of 90 pieces of Novartis Glivec.

(PhysOrg.com) -- New medical trials suggest some chronic leukemia patients who are in complete remission may be cured by the standard drug used to treat the condition and can safely discontinue its use.

The trials showed that when doctors stopped treating (CML) patients with the standard drug imatinib (also called Glivec) some remained completely free of the disease two years later. This contradicts the prevalent belief the treatment should be continued for life because the leukemia would always return if treatment was stopped due to the presence of leukemia-initiating resistant to imatinib.

The research team, led by Professor François-Xavier Mahon of the Victor Segalen Bordeaux University in France, aimed to find out if treatment with imatinib for CML could be safely discontinued, since little research on this had been done and the drug treatment is expensive. Their study, called the Stop Imatinib (STIM) study, was a prospective, non-randomized trial of 69 CML patients at 19 medical institutions in France. All participants had been taking imatinib for at least two years and were in stable "complete molecular " (CMR).

The results were that of the 69 patients followed for at least 12 months, 42 patients (61 percent) relapsed, with 40 of them relapsing in the first six months. The remaining patients did not suffer relapse in the two years they were followed. Imatinib treatment was reinstated for all patients who relapsed and all of them responded well.

The researchers concluded the results of this interim study suggest if patients have been in remission for at least two years it may be possible to discontinue the drug safely, and some patients will remain in remission, effectively having been cured by the drug. The results also suggest a better prognosis can be expected for male patients who have been treated for a long period with imatinib and who have a low prognostic Sokal score. Longer-term studies are continuing.

Chronic myeloid leukemia is a slow-developing form of . The majority of people with CML have a genetic abnormality in their blood cells called the Philadelphia (Ph) chromosome, which causes the production of an enzyme called tyrosine kinase. The enzyme produces an abnormal protein called BCR/ABL. Imatinib, a tyrosine-kinase inhibitor, is a standard drug for the disease but does not often produce complete remission. For this reason the option of discontinuing imatinib will only apply to around 10 percent of CML patients.

The paper was published online in the journal The Lancet Oncology and will appear in the print version of the journal.

Explore further: Can cancer drugs combine forces?

More information: Discontinuation of imatinib in patients with chronic myeloid leukaemia who have maintained complete molecular remission for at least 2 years: the prospective, multicentre Stop Imatinib (STIM) trial, The Lancet Oncology, Early Online Publication, 20 October 2010. doi:10.1016/S1470-2045(10)70233-3

Related Stories

Can cancer drugs combine forces?

August 16, 2007

Individuals with chronic myeloid leukemia (CML) are treated first with a drug known as imatinib (Gleevec), which targets the protein known to cause the cancer (BCR-ABL). If their disease returns, because BCR-ABL mutants emerge ...

Second-generation CML drugs show promise as frontline therapy

December 8, 2008

Two drugs approved as fallback therapy for chronic myelogenous leukemia (CML) appear to outperform historical benchmarks of the frontline medication when used as a first treatment in separate clinical trials, researchers ...

Recommended for you

Cow embryos reveal new type of chromosome chimera

May 27, 2016

I've often wondered what happens between the time an egg is fertilized and the time the ball of cells that it becomes nestles into the uterine lining. It's a period that we know very little about, a black box of developmental ...

How the finch changes its tune

August 3, 2015

Like top musicians, songbirds train from a young age to weed out errors and trim variability from their songs, ultimately becoming consistent and reliable performers. But as with human musicians, even the best are not machines. ...

Shaving time to test antidotes for nerve agents

February 29, 2016

Imagine you wanted to know how much energy it took to bike up a mountain, but couldn't finish the ride to the peak yourself. So, to get the total energy required, you and a team of friends strap energy meters to your bikes ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

poihths
not rated yet Oct 24, 2010
This result tends to confirm the preliminary result found by Rousselot et. al. in 2007. See "Imatinib mesylate discontinuation....", Blood. 2007;109:58-60.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.