{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:01:26Z","timestamp":1791331286661,"version":"4.3.1"},"reference-count":28,"publisher":"Wiley","issue":"22","license":[{"start":{"date-parts":[[2017,7,25]],"date-time":"2017-07-25T00:00:00Z","timestamp":1500940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2017,11,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Several studies have demonstrated that approximately one\u2010half of patients with chronic myeloid leukemia (CML) who receive treatment with tyrosine kinase inhibitors (TKIs) and achieve and maintain a deep molecular response (DMR) are able to successfully discontinue therapy. In patients who have a molecular relapse, a DMR is rapidly regained upon treatment re\u2010initiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors report the results from RE\u2010STIM, a French observational, multicenter study that evaluated treatment\u2010free remission (TFR) in 70 patients who re\u2010attempted TKI discontinuation after a first unsuccessful attempt. After the second TKI discontinuation attempt, the trigger for treatment re\u2010introduction was the loss of a major molecular response in all patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The median follow\u2010up was 38.3 months (range, 4.7\u2010117 months), and 45 patients (64.3%) lost a major molecular response after a median time off therapy of 5.3 months (range, 2\u201042 months). TFR rates at 12, 24, and 36 months were 48% (95% confidence interval [CI], 37.6%\u201061.5%), 42% (95% CI, 31.5%\u201055.4%), and 35% (95% CI, 24.4%\u201049.4%), respectively. No progression toward advanced\u2010phase CML occurred, and no efficacy issue was observed upon TKI re\u2010introduction. In univariate analysis, the speed of molecular relapse after the first TKI discontinuation attempt was the only factor significantly associated with outcome. The TFR rate at 24 months was 72% (95% CI, 48.8%\u2010100%) in patients who remained in DMR within the first 3 months after the first TKI discontinuation and 36% (95% CI, 25.8%\u201051.3%) for others.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>This study is the first to demonstrate that a second TKI discontinuation attempt is safe and that a first failed attempt at discontinuing TKI does not preclude a second successful attempt. <jats:bold><jats:italic>Cancer<\/jats:italic> 2017;123:4403\u201010<\/jats:bold>. \u00a9 <jats:italic>2017 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30885","type":"journal-article","created":{"date-parts":[[2017,7,25]],"date-time":"2017-07-25T17:42:37Z","timestamp":1501004557000},"page":"4403-4410","source":"Crossref","is-referenced-by-count":99,"title":["Second tyrosine kinase inhibitor discontinuation attempt in patients with chronic myeloid leukemia"],"prefix":"10.1002","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9567-7879","authenticated-orcid":false,"given":"Laurence","family":"Legros","sequence":"first","affiliation":[{"name":"Hematology Department Nice University Hospital Nice France"},{"name":"Valrose Institute of Biology, National Center for Scientific Research (CNRS) Unit 7277, National Institute of Health and Medical Research (INSERM) Unit 1091 Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franck E.","family":"Nicolini","sequence":"additional","affiliation":[{"name":"Hematology Department, Lyon University Hospital Pierre Benite France"},{"name":"INSERM Unit 1052, Leon Berard Center Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Etienne","sequence":"additional","affiliation":[{"name":"Haematology Department, Bergonie Institute Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Rousselot","sequence":"additional","affiliation":[{"name":"Haematology and Oncology Department Hopital A Mignot, INSERM Unit 1173, Versailles, University of Versailles St.\u2010Quentin\u2010Yvelines  France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Rea","sequence":"additional","affiliation":[{"name":"Adult Hematology Department, INSERM Unit 1160, St. Louis Hospital Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Giraudier","sequence":"additional","affiliation":[{"name":"Hematology Laboratory, Henri\u2010Mondor Hospital Creteil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agn\u00e8s","family":"Guerci\u2010Bresler","sequence":"additional","affiliation":[{"name":"Hematology Department, Brabois University Hospital, Vandoeuvre\u2010les\u2010Nancy  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