Abstract
Despite the remarkable success of tyrosine kinase inhibitors (TKIs) in the treatment of CML, patients that do not respond or do not tolerate well these agents accumulate, and new options have to be found to avoid these situations. In this chapter, we discuss the importance of ponatinib, a third-generation TKI, and omacetaxine mepesuccinate, an untargeted therapy for such patients, and the use of combinations of TKI and interferon-α front line in order to prevent the onset of disease resistance.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
de Lavallade H, Apperley JF, Khorashad JS, Milojkovic D, Reid AG, Bua M, et al. Imatinib for newly diagnosed patients with chronic myeloid leukemia: incidence of sustained responses in an intention-to-treat analysis. J Clin Oncol. 2008;26(20):3358–63.
Deininger M, O’Brien SG, Guilhot F. International randomized study of interferon vs STI571 (IRIS) 8-year follow up: sustained survival and low risk for progression or events in patients with newly diagnosed chronic myeloid leukemia in chronic phase (CML-CP) treated with imatinib. Blood. 2009;114(22):1126.
Cortes JE, Kantarjian H, Shah NP, Bixby D, Mauro MJ, Flinn I, et al. Ponatinib in refractory Philadelphia chromosome-positive leukemias. N Engl J Med. 2012;367(22):2075–88.
Cortes JE, Kim DW, Pinilla-Ibarz J, le Coutre P, Paquette R, Chuah C, et al. A phase 2 trial of ponatinib in Philadelphia chromosome-positive leukemias. N Engl J Med. 2013;369(19):1783–96.
Hamilton A, Helgason GV, Schemionek M, Zhang B, Myssina S, Allan EK, et al. Chronic myeloid leukemia stem cells are not dependent on Bcr-Abl kinase activity for their survival. Blood. 2012;119(6):1501–10.
Talpaz M, McCredie KB, Mavligit GM, Gutterman JU. Leukocyte interferon-induced myeloid cytoreduction in chronic myelogenous leukemia. Blood. 1983;62(3):689–92.
Bonifazi F, de Vivo A, Rosti G, Guilhot F, Guilhot J, Trabacchi E, et al. Chronic myeloid leukemia and interferon-alpha: a study of complete cytogenetic responders. Blood. 2001;98(10):3074–81.
Cortes J, Jabbour E, Kantarjian H, Yin CC, Shan J, O’Brien S, et al. Dynamics of BCR-ABL kinase domain mutations in chronic myeloid leukemia after sequential treatment with multiple tyrosine kinase inhibitors. Blood. 2007;110(12):4005–11.
Nicolini FE, Corm S, Le QH, Sorel N, Hayette S, Bories D, et al. Mutation status and clinical outcome of 89 imatinib mesylate-resistant chronic myelogenous leukemia patients: a retrospective analysis from the French intergroup of CML (Fi(j)-LMC group). Leukemia. 2006;20(6):1061–6.
Nicolini FE, Ibrahim AR, Soverini S, Martinelli G, Muller MC, Hochhaus A, et al. The BCR-ABLT315I mutation compromises survival in chronic phase chronic myelogenous leukemia patients resistant to tyrosine kinase inhibitors, in a matched pair analysis. Haematologica. 2013;98(10):1510–6.
Soverini S, Colarossi S, Gnani A, Rosti G, Castagnetti F, Poerio A, et al. Contribution of ABL kinase domain mutations to imatinib resistance in different subsets of Philadelphia-positive patients: by the GIMEMA Working Party on Chronic Myeloid Leukemia. Clin Cancer Res. 2006;12(24):7374–9.
Nicolini FE, Basak GW, Soverini S, Martinelli G, Mauro MJ, Muller MC, et al. Allogeneic stem cell transplantation for patients harboring T315I BCR-ABL mutated leukemias. Blood. 2011;118(20):5697–700.
Nicolini FE, Corm S, Le QH, Roche-Lestienne C, Preudhomme C. The prognosis impact of BCR-ABL P-loop mutations: worse or not worse? Leukemia. 2007;21(2):193–4.
Cortes JE, Kim DW, Pinilla-Ibarz J, Le Coutre P, Paquette R, Chuah C, et al. Long-term follow-up of ponatinib efficacy and safety in the Phase 2 PACE Trial. Blood. 2014;124(21): Abstract 3135.
Nicolini FE, Gagnieu MC, Heiblig M, Blond E, Legros L, Guillermin Y. Cardio-vascular events occurring on ponatinib In chronic phase Chronic Myeloid Leukemia patients, preliminary analysis of a multicenter cohort. Blood. 2013;122(21): Abstract 4020.
Corm S, Roche L, Micol JB, Coiteux V, Bossard N, Nicolini FE, et al. Changes in the dynamics of the excess mortality rate in chronic phase-chronic myeloid leukemia over 1990-2007: a population study. Blood. 2011;118(16):4331–7.
O’Brien S, Kantarjian H, Keating M, Beran M, Koller C, Robertson LE, et al. Homoharringtonine therapy induces responses in patients with chronic myelogenous leukemia in late chronic phase. Blood. 1995;86(9):3322–6.
Kantarjian HM, Talpaz M, Santini V, Murgo A, Cheson B, O’Brien SM. Homoharringtonine: history, current research, and future direction. Cancer. 2001;92(6):1591–605.
Cortes J, Digumarti R, Parikh PM, Wetzler M, Lipton JH, Hochhaus A, et al. Phase 2 study of subcutaneous omacetaxine mepesuccinate for chronic-phase chronic myeloid leukemia patients resistant to or intolerant of tyrosine kinase inhibitors. Am J Hematol. 2013;88(5):350–4.
Nicolini FE, Chomel JC, Roy L, Legros L, Chabane K, Ducastelle S, et al. The durable clearance of the T315I BCR-ABL mutated clone in chronic phase chronic myelogenous leukemia patients on omacetaxine allows tyrosine kinase inhibitor rechallenge. Clin Lymphoma Myeloma Leuk. 2010;10(5):394–9.
Legros L, Hayette S, Nicolini FE, Raynaud S, Chabane K, Magaud JP, et al. BCR-ABL(T315I) transcript disappearance in an imatinib-resistant CML patient treated with homoharringtonine: a new therapeutic challenge? Leukemia. 2007;21(10):2204–6.
O’Brien S, Talpaz M, Cortes J, Shan J, Giles FJ, Faderl S, et al. Simultaneous homoharringtonine and interferon-alpha in the treatment of patients with chronic-phase chronic myelogenous leukemia. Cancer. 2002;94(7):2024–32.
Burton C, Ranger A, Nadal E. Semi-synthetic homoharringtonine (MyelostatVR) for chronic myeloid leukemia in accelerated phase after imatinib failure. Blood. 2003;102(908): Abstract.
Marin D, Kaeda JS, Andreasson C, Saunders SM, Bua M, Olavarria E, et al. Phase I/II trial of adding semisynthetic homoharringtonine in chronic myeloid leukemia patients who have achieved partial or complete cytogenetic response on imatinib. Cancer. 2005;103(9):1850–5.
O’Brien S, Giles F, Talpaz M, Cortes J, Rios MB, Shan J, et al. Results of triple therapy with interferon-alpha, cytarabine, and homoharringtonine, and the impact of adding imatinib to the treatment sequence in patients with Philadelphia chromosome-positive chronic myelogenous leukemia in early chronic phase. Cancer. 2003;98(5):888–93.
Cortes JE, Nicolini FE, Wetzler M, Lipton JH, Akard L, Craig A, et al. Subcutaneous omacetaxine mepesuccinate in patients with chronic-phase chronic myeloid leukemia previously treated with 2 or more tyrosine kinase inhibitors including imatinib. Clin Lymphoma Myeloma Leuk. 2013;13(5):584–91.
Nicolini FE, Khoury HJ, Akard L, Rea D, Kantarjian H, Baccarani M, et al. Omacetaxine mepesuccinate for patients with accelerated phase chronic myeloid leukemia with resistance or intolerance to two or more tyrosine kinase inhibitors. Haematologica. 2013;98(7):78–9.
de Lavallade H, Khorashad JS, Davis HP, Milojkovic D, Kaeda JS, Goldman JM, et al. Interferon-alpha or homoharringtonine as salvage treatment for chronic myeloid leukemia patients who acquire the T315I BCR-ABL mutation. Blood. 2007;110(7):2779–80.
Coude MM, Luycx O, Cariou ME, Maarek O, Dombret H, Cayuela JM, et al. Undetectable molecular residual disease after omacetaxine and nilotinib combination therapy in an imatinib-resistant chronic myeloid leukaemia patient harbouring the BCR-ABL1 T315I gatekeeper mutation. Br J Haematol. 2012;157(3):407–10.
Cortes J, Lipton JH, Rea D, Digumarti R, Chuah C, Nanda N, et al. Phase 2 study of subcutaneous omacetaxine mepesuccinate after TKI failure in patients with chronic-phase CML with T315I mutation. Blood. 2012;120(13):2573–80.
Khoury HJ, Cortes J, Baccarani M, Wetzler M, Masszi T, Digumarti R, et al. Omacetaxine mepesuccinate in patients with advanced chronic myeloid leukemia with resistance or intolerance to tyrosine kinase inhibitors. Leuk Lymphoma. 2015;56(1):120–7.
Nicolini FE, Hayette S, Legros L, Rousselot P, Maloisel F, Tulliez M, et al. Pegylated IFN-alpha2a combined to imatinib mesylate 600mg daily can induce complete cytogenetic and molecular responses in a subset of chronic phase CML patients refractory to IFN alone or to imatinib 600mg daily alone. Leuk Res. 2011;35(1):80–6.
Preudhomme C, Guilhot J, Nicolini FE, Guerci-Bresler A, Rigal-Huguet F, Maloisel F, et al. Imatinib plus peginterferon alfa-2a in chronic myeloid leukemia. N Engl J Med. 2010;363(26):2511–21.
Baccarani M, Martinelli G, Rosti G, Trabacchi E, Testoni N, Bassi S, et al. Imatinib and pegylated human recombinant interferon-alpha2b in early chronic-phase chronic myeloid leukemia. Blood. 2004;104(13):4245–51.
Simonsson B, Gedde-Dahl T, Markevarn B, Remes K, Stentoft J, Almqvist A, et al. Combination of pegylated IFN-alpha2b with imatinib increases molecular response rates in patients with low- or intermediate-risk chronic myeloid leukemia. Blood. 2011;118(12):3228–35.
Palandri F, Iacobucci I, Castagnetti F, Testoni N, Poerio A, Amabile M, et al. Front-line treatment of Philadelphia positive chronic myeloid leukemia with imatinib and interferon-alpha: 5-year outcome. Haematologica. 2008;93(5):770–4.
Kantarjian HM, Hochhaus A, Saglio G, De Souza C, Flinn IW, Stenke L, et al. Nilotinib versus imatinib for the treatment of patients with newly diagnosed chronic phase, Philadelphia chromosome-positive, chronic myeloid leukaemia: 24-month minimum follow-up of the phase 3 randomised ENESTnd trial. Lancet Oncol. 2011;12(9):841–51.
Kantarjian HM, Shah NP, Cortes JE, Baccarani M, Agarwal MB, Undurraga MS, et al. Dasatinib or imatinib in newly diagnosed chronic-phase chronic myeloid leukemia: 2-year follow-up from a randomized phase 3 trial (DASISION). Blood. 2012;119(5):1123–9.
Cross NC, White HE, Muller MC, Saglio G, Hochhaus A. Standardized definitions of molecular response in chronic myeloid leukemia. Leukemia. 2012;26(10):2172–5.
Nicolini FE, Etienne G, Dubruille V, Roy L, Huguet F, Legros L, et al. Nilotinib and peginterferon alfa-2a for newly diagnosed chronic-phase chronic myeloid leukaemia (NiloPeg): a multicentre, non-randomised, open-label phase 2 study. Lancet Haematol. 2015;2(1):37–46.
O’Brien S, Kantarjian H, Koller C, Feldman E, Beran M, Andreeff M, et al. Sequential homoharringtonine and interferon-alpha in the treatment of early chronic phase chronic myelogenous leukemia. Blood. 1999;93(12):4149–53.
Kantarjian HM, Talpaz M, Smith TL, Cortes J, Giles FJ, Rios MB, et al. Homoharringtonine and low-dose cytarabine in the management of late chronic-phase chronic myelogenous leukemia. J Clin Oncol. 2000;18(20):3513–21.
Rea D, Nicolini FE, Tulliez M, Rousselot P, Guilhot F, Gardembas M, et al. Dasatinib or nilotinib discontinuation in chronic phase (CP)-Chronic Myeloid Leukemia (CML) patients (pts) with durably undetectable BCR-ABL transcripts: Interim analysis of the STOP 2G-TKI study with a minimum follow-up of 12 months – on behalf of the French CML Group Filmc. Blood. 2014;124(21): Abstract 811.
Acknowledgments
FEN thanks Barbara White-Meunier, for proofreading this book chapter and the association “Regarde un jour le monde” for their constant support.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer Japan
About this chapter
Cite this chapter
Nicolini, F.E., Balsat, M., Labussière-Wallet, H., Sobh, M., Bert, A., Heiblig, M. (2016). The Role of New TKIs and Combinations with Interferon-α for the Treatment of CML. In: Kizaki, M. (eds) Molecular Pathogenesis and Treatment of Chronic Myelogenous Leukemia. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55714-2_9
Download citation
DOI: https://doi.org/10.1007/978-4-431-55714-2_9
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-55713-5
Online ISBN: 978-4-431-55714-2
eBook Packages: MedicineMedicine (R0)