Abstract 1904
Background
The management of Chronic Myeloid Leukemia (CML) has undergone a paradigm shift with advent of the tyrosine kinase inhibitor (TKI), namely imatinib. Despite a high remission rate, a significant proportion of patients showed resistance and/or intolerance to imatinib therapy, be it primary or secondary. However, the scenario of resistance along with the prevalence and clinical route of CML in the Eastern part of India remains elusive. To observe the incidence of resistance to TKI after years of therapy, we performed a study in a tertiary cancer care centre, serving patients from Eastern Indian states as well as neighbor countries like Bangladesh and Bhutan. Based on the CML cases registered at the centre for the last 13 years, we performed a longitudinal assessment of the disease history and molecular management to portray the incidence of imatinib resistance in CML patients.
Methods
The methods in schematic are described below: No. of CML cases with disease history ↓ Patients showing loss of Major Molecular Response (MMR), detected by Real-Time quantitative PCR ↓ Mutation analysis in BCR-ABL kinase domain (KD) (by Sanger sequencing) ↓ Calculation of type and incidence of KD mutation ↓ The survival analyses performed by Kaplan-Meier analysis.
Results
The results are presented in tabular form as below:.Table: 1098P
No. of registered CML cases (2005-2017) | Median period of Imatinib treatment | No. of patients showing Loss of MMR (BCR-ABL >1.0%) | No. of patients undergoing BCR-ABL KD mutation testing (% affordability) | No. of patients showing BCR-ABL KD mutation | Patients with Imatinib failure but no detectable BCR-ABL KD mutation |
---|---|---|---|---|---|
986 | 26 months | 101 | 20 (20%) | 11 (55% of resistant pool) | 9 (45% of resistant pool) |
After years of therapy, KD mutations are seen in 55% of imatinib-resistant patients. The survival analysis showed significant difference between treatment-sensitive and –resistant pools.
Conclusions
The incidence of imatinib resistance has been increasingly detected in Eastern-Indian region after long term therapy with imatinib. However, the full scenario could not be depicted due to resource constraints. More numbers of patients are to be tested to achieve robust evidence.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3620 - Safety, efficacy, PK and PD biomarker results of the first-in-human study of mutant isocitrate dehydrogenase 1 (mIDH1) inhibitor BAY 1436032 in patients (pts) with mIDH1 advanced solid tumours
Presenter: Wolfgang Wick
Session: Poster Display session 1
Resources:
Abstract
5465 - Proof of concept clinical study by US-guided intratumor injection of VCN-01, an oncolytic adenovirus expressing hyaluronidase in patients with pancreatic cancer
Presenter: Manuel Hidalgo
Session: Poster Display session 1
Resources:
Abstract
2555 - A Phase 1a/b first-in-human, open-label, dose-escalation, safety, PK and PD study of TP-0903 in solid tumors
Presenter: John Sarantopoulos
Session: Poster Display session 1
Resources:
Abstract
3533 - First in human phase 1/2a study of PEN-866, a Heat Shock Protein 90 (HSP90) ligand – SN38 conjugate for patients with advanced solid tumors: Phase 1 results
Presenter: Johanna Bendell
Session: Poster Display session 1
Resources:
Abstract
4114 - A Phase I Open-Label, Non-Randomized Study of Recombinant Super-Compound Interferon (rSIFN-co) In Patients with Advanced Solid Tumors
Presenter: Amanda Seet
Session: Poster Display session 1
Resources:
Abstract
2537 - Evaluation of Pharmacodynamic (PD) Biomarkers in Advanced Cancer Patients Treated with Oxidative Phosphorylation (OXPHOS) Inhibitor, OPC-317 (OPC)
Presenter: Jie Qing Eu
Session: Poster Display session 1
Resources:
Abstract
5764 - Pharmacokinetic (PK) assessment of BT1718: A phase 1/2a study of BT1718, a first in class Bicycle Toxin Conjugate (BTC), in patients (pts) with advanced solid tumours
Presenter: Natalie Cook
Session: Poster Display session 1
Resources:
Abstract
2683 - A phase I open label dose escalation trial evaluating VT1021 in patients with advanced solid tumors.
Presenter: Wael Harb
Session: Poster Display session 1
Resources:
Abstract
3609 - Interim Results from Trial of SL-801, a Novel XPO-1 Inhibitor, in Patients with Advanced Solid Tumors
Presenter: Judy Wang
Session: Poster Display session 1
Resources:
Abstract
3485 - Phase 1 Trial of Fruquintinib in Patients with Advanced Solid Tumors: Results of the Dose Escalation Phase
Presenter: Andrea Wang-Gillam
Session: Poster Display session 1
Resources:
Abstract