Abstract 1940
Background
Few chronic myeloid leukemia (CML) patients may stop responding to tyrosine kinase inhibitors (TKI). On mutational analysis, the most common mutation detected is T315I conferring resistance to all TKIs except ponatinib, availability of which is limited. Management of these patients, in the absence of ponatinib is allogenic hematopoietic stem transplantation. Data on outcomes of the patients with this mutation in the absence these modalities is limited. The present study was planned to study the profile and outcomes of CML patients with T315I mutation treated with hydroxyurea and supportive care.
Methods
Data of CML patients with T315I mutation who failed on imatinib diagnosed between 2004 and 2018 was retrospectively analyzed.
Results
A total of 2162 patients were analyzed. Of these, 312 (14.4%) were imatinib failures. Mutations were seen in 120 (38.5%) patients, of which 45 (37.5%) patients had T315I mutation. Reasons for mutational analysis testing were not attaining MMR at 1 year, loss of molecular response and loss of hematological response in 3(6.7%), 35(77.8%) and 7(15.6%) patients respectively. The median duration from diagnosis to T315I detection was 38 months (range, 6-146). At the time of detection of T315I mutation, CP, AP and BP were detected in 19 (42.2%), 12(26.7%) and 14 (31.1%) patients respectively. At a median follow up of 18 months, 19 patients were alive and 26 patients were dead with a median overall survival (mOS) of 18 months (range, 0-122). mOS of patients with CP, AP and BP were not reached (range, 2-122) 12 (range, 1-81) and 3 (range, 0.3-34) months respectively (p = 0.001). Table.Table: 1096P
Characteristic | N (%) |
---|---|
Median age (years) | 37 (range, 6-60) |
Gender Males Females | 32 13 |
Phase CP AP BP | 35 (77.8) 8 (17.8) 2 (4.4) |
EUTOS risk Low High | 22 (48.9) 23 (51.2) |
Conclusions
T315I was the most common mutation detected in patients who had not attained MMR or progressed on imatinib. Majority of patients were in chronic phase at time of T315I detection. Phase at the time of detection of T315I had significant impact on outcomes in the absence of targeted therapy or allogenic stem cell transplantation.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Nizam’s Institute of Medical Sciences.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4325 - Multiple synchronous mechanisms may contribute to osimertinib resistance in non-small cell lung cancer (NSCLC) patients: insights of the MATCH-R study
Presenter: Diego Enrico
Session: Poster Display session 1
Resources:
Abstract
2185 - Sequential treatment with afatinib followed by 3rd generation EGFR-TKI – subgroup analysis of the GIDEON trial: a prospective non-interventional study (NIS) in EGFR mutated NSCLC patients in Germany
Presenter: Wolfgang Brückl
Session: Poster Display session 1
Resources:
Abstract
1524 - Effectiveness of sequencing TKIs in patients with EGFR mutation-positive Non-small-Cell Lung Cancer (NSCLC): A French National medico administrative claim database analysis
Presenter: Nicolas Girard
Session: Poster Display session 1
Resources:
Abstract
5733 - Phase II study of osimertinib in NSCLC patients with EGFR exon 20 insertion mutation: A multicenter trial of the Korean Cancer Study Group (LU17-19)
Presenter: Tae Min Kim
Session: Poster Display session 1
Resources:
Abstract
5440 - Different stories for different EGFR exon 19 deletion variants
Presenter: Chao Zhao
Session: Poster Display session 1
Resources:
Abstract
2982 - Safety and activity of alflutinib in patients with advanced EGFR T790M mutation non-small cell lung cancer who progressed after EGFR-TKI therapy
Presenter: Yuan-Kai Shi
Session: Poster Display session 1
Resources:
Abstract
4002 - Afatinib followed by osimertinib in patients with EGFR mutation-positive (EGFRm+) advanced NSCLC: updated data from the GioTag real-world study
Presenter: Maximilian Hochmair
Session: Poster Display session 1
Resources:
Abstract
2941 - Treatment patterns of EGFR mt+ NSCLC IV pts: Real world data of the NOWEL network
Presenter: Julia Roeper
Session: Poster Display session 1
Resources:
Abstract
4154 - TP53 mutations predicts worse prognosis in EGFR-mutated NSCLC patients receiving TKIs in first- or further line of treatment
Presenter: Matteo Canale
Session: Poster Display session 1
Resources:
Abstract
1175 - HER3 ligand heregulin expression and clinical implication in patients with epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer treated with EGFR-tyrosine kinase inhibitors
Presenter: Kimio Yonesaka
Session: Poster Display session 1
Resources:
Abstract