Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer. 2011 Jan 15;117(2):327-35. doi: 10.1002/cncr.25604. Epub 2010 Sep 15.
Imatinib is an effective tyrosine kinase inhibitor (TKI) for patients with chronic myeloid leukemia (CML) in chronic phase (CP). Although some patients may fail on therapy with imatinib, effective salvage therapy is available with second-generation TKIs. Current measurement of efficacy for each therapy is judged by its individual impact on overall survival and event-free survival (EFS).
In total, 586 patients with CML in CP who received imatinib were included in this analysis in 2 cohorts: imatinib as front-line therapy (n = 281) or after failure on interferon-α (IFN-α) (n = 305). By accounting for successful salvage treatment (ie, regain of complete cytogenetic response), the current EFS (CEFS) rate was calculated to obtain a more accurate impression of the outcome of patients with CML who received treatment with sequential TKIs.
For patients who received imatinib after failing on IFN-α, the 7-year EFS rate was 61%, whereas the CEFS rate was 69%. The 7-year EFS rate for patients who received imatinib as initial therapy was 81% compared with a 7-year CEFS rate of 88%.
CEFS provided a more accurate representation of the outcome of patients with CML in CP. These patients may frequently be treated successfully with subsequent TKIs after experiencing failure on the first TKI.
伊马替尼是一种有效的酪氨酸激酶抑制剂（TKI），适用于慢性期（CP）慢性髓性白血病（CML）患者。尽管一些患者可能会对伊马替尼治疗产生耐药，但仍有有效的二线 TKI 治疗方案。目前，每种治疗方法的疗效评估均通过其对总生存（OS）和无事件生存（EFS）的个体影响来判断。
本分析共纳入 586 例接受伊马替尼治疗的 CP 期 CML 患者，分为 2 个队列：一线治疗（n=281）或 IFN-α（IFN-α）治疗失败后（n=305）。通过对成功挽救治疗（即完全细胞遗传学缓解的恢复）进行核算，计算当前 EFS（CEFS）率，以更准确地评估接受序贯 TKI 治疗的 CML 患者的治疗结局。
对于 IFN-α 治疗失败后接受伊马替尼治疗的患者，7 年 EFS 率为 61%，而 CEFS 率为 69%。一线治疗接受伊马替尼治疗的患者 7 年 EFS 率为 81%，而 7 年 CEFS 率为 88%。
CEFS 更准确地反映了 CP 期 CML 患者的治疗结局。这些患者在一线 TKI 治疗失败后，常可通过后续 TKI 治疗成功治愈。
