A phase 3, open-label, randomized study of asciminib, a STAMP inhibitor, vs bosutinib in CML after 2 or more prior TKIs
Patients with chronic myeloid leukemia in chronic phase (CML-CP) resistant/intolerant to ≥2 tyrosine kinase inhibitors (TKIs) are at high risk of experiencing poor outcomes because of disease biology and inadequate efficacy and/or safety of current therapies. Asciminib, a first-in-class BCR-ABL1 inh...
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Published in | Blood Vol. 138; no. 21; pp. 2031 - 2041 |
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Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Elsevier Inc
25.11.2021
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Subjects | |
Online Access | Get full text |
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Abstract | Patients with chronic myeloid leukemia in chronic phase (CML-CP) resistant/intolerant to ≥2 tyrosine kinase inhibitors (TKIs) are at high risk of experiencing poor outcomes because of disease biology and inadequate efficacy and/or safety of current therapies. Asciminib, a first-in-class BCR-ABL1 inhibitor Specifically Targeting the ABL Myristoyl Pocket (STAMP), has the potential to overcome resistance/intolerance to approved TKIs. In this phase 3, open-label study, patients with CML-CP previously treated with ≥2 TKIs were randomized (2:1) to receive asciminib 40 mg twice daily vs bosutinib 500 mg once daily. Randomization was stratified by major cytogenetic response (MCyR) status at baseline. The primary objective was to compare the major molecular response (MMR) rate at week 24 for asciminib vs bosutinib. A total of 233 patients were randomized to asciminib (n = 157) or bosutinib (n = 76). Median follow-up was 14.9 months. The MMR rate at week 24 was 25.5% with asciminib and 13.2% with bosutinib. The difference in MMR rate between treatment arms, after adjusting for MCyR at baseline, was 12.2% (95% confidence interval, 2.19-22.30; 2-sided P = .029). Fewer grade ≥3 adverse events (50.6% vs 60.5%) and adverse events leading to treatment discontinuation (5.8% vs 21.1%) occurred with asciminib than with bosutinib. The study showed a superior efficacy of asciminib compared with that of bosutinib, together with a favorable safety profile. These results support the use of asciminib as a new therapy in patients with CML-CP who are resistant/intolerant to ≥2 prior TKIs. This trial was registered at www.clinicaltrials.gov as #NCT03106779.
•Asciminib demonstrated superior efficacy vs bosutinib and an improved safety profile in patients with CML-CP after at least 2 prior TKIs.•Asciminib has the potential to transform standard of care in this population through its novel mechanism of action as a STAMP inhibitor.
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AbstractList | Patients with chronic myeloid leukemia in chronic phase (CML-CP) resistant/intolerant to ≥2 tyrosine kinase inhibitors (TKIs) are at high risk of experiencing poor outcomes because of disease biology and inadequate efficacy and/or safety of current therapies. Asciminib, a first-in-class BCR-ABL1 inhibitor Specifically Targeting the ABL Myristoyl Pocket (STAMP), has the potential to overcome resistance/intolerance to approved TKIs. In this phase 3, open-label study, patients with CML-CP previously treated with ≥2 TKIs were randomized (2:1) to receive asciminib 40 mg twice daily vs bosutinib 500 mg once daily. Randomization was stratified by major cytogenetic response (MCyR) status at baseline. The primary objective was to compare the major molecular response (MMR) rate at week 24 for asciminib vs bosutinib. A total of 233 patients were randomized to asciminib (n = 157) or bosutinib (n = 76). Median follow-up was 14.9 months. The MMR rate at week 24 was 25.5% with asciminib and 13.2% with bosutinib. The difference in MMR rate between treatment arms, after adjusting for MCyR at baseline, was 12.2% (95% confidence interval, 2.19-22.30; 2-sided P = .029). Fewer grade ≥3 adverse events (50.6% vs 60.5%) and adverse events leading to treatment discontinuation (5.8% vs 21.1%) occurred with asciminib than with bosutinib. The study showed a superior efficacy of asciminib compared with that of bosutinib, together with a favorable safety profile. These results support the use of asciminib as a new therapy in patients with CML-CP who are resistant/intolerant to ≥2 prior TKIs. This trial was registered at www.clinicaltrials.gov as #NCT03106779.
•Asciminib demonstrated superior efficacy vs bosutinib and an improved safety profile in patients with CML-CP after at least 2 prior TKIs.•Asciminib has the potential to transform standard of care in this population through its novel mechanism of action as a STAMP inhibitor.
[Display omitted] Patients with chronic myeloid leukemia in chronic phase (CML-CP) resistant/intolerant to ≥2 tyrosine kinase inhibitors (TKIs) are at high risk of experiencing poor outcomes because of disease biology and inadequate efficacy and/or safety of current therapies. Asciminib, a first-in-class BCR-ABL1 inhibitor Specifically Targeting the ABL Myristoyl Pocket (STAMP), has the potential to overcome resistance/intolerance to approved TKIs. In this phase 3, open-label study, patients with CML-CP previously treated with ≥2 TKIs were randomized (2:1) to receive asciminib 40 mg twice daily vs bosutinib 500 mg once daily. Randomization was stratified by major cytogenetic response (MCyR) status at baseline. The primary objective was to compare the major molecular response (MMR) rate at week 24 for asciminib vs bosutinib. A total of 233 patients were randomized to asciminib (n = 157) or bosutinib (n = 76). Median follow-up was 14.9 months. The MMR rate at week 24 was 25.5% with asciminib and 13.2% with bosutinib. The difference in MMR rate between treatment arms, after adjusting for MCyR at baseline, was 12.2% (95% confidence interval, 2.19-22.30; 2-sided P = .029). Fewer grade ≥3 adverse events (50.6% vs 60.5%) and adverse events leading to treatment discontinuation (5.8% vs 21.1%) occurred with asciminib than with bosutinib. The study showed a superior efficacy of asciminib compared with that of bosutinib, together with a favorable safety profile. These results support the use of asciminib as a new therapy in patients with CML-CP who are resistant/intolerant to ≥2 prior TKIs. This trial was registered at www.clinicaltrials.gov as #NCT03106779. Patients with chronic myeloid leukemia in chronic phase (CML-CP) resistant/intolerant to ≥2 tyrosine kinase inhibitors (TKIs) are at high risk of experiencing poor outcomes because of disease biology and inadequate efficacy and/or safety of current therapies. Asciminib, a first-in-class BCR-ABL1 inhibitor Specifically Targeting the ABL Myristoyl Pocket (STAMP), has the potential to overcome resistance/intolerance to approved TKIs. In this phase 3, open-label study, patients with CML-CP previously treated with ≥2 TKIs were randomized (2:1) to receive asciminib 40 mg twice daily vs bosutinib 500 mg once daily. Randomization was stratified by major cytogenetic response (MCyR) status at baseline. The primary objective was to compare the major molecular response (MMR) rate at week 24 for asciminib vs bosutinib. A total of 233 patients were randomized to asciminib (n = 157) or bosutinib (n = 76). Median follow-up was 14.9 months. The MMR rate at week 24 was 25.5% with asciminib and 13.2% with bosutinib. The difference in MMR rate between treatment arms, after adjusting for MCyR at baseline, was 12.2% (95% confidence interval, 2.19-22.30; 2-sided P = .029). Fewer grade ≥3 adverse events (50.6% vs 60.5%) and adverse events leading to treatment discontinuation (5.8% vs 21.1%) occurred with asciminib than with bosutinib. The study showed a superior efficacy of asciminib compared with that of bosutinib, together with a favorable safety profile. These results support the use of asciminib as a new therapy in patients with CML-CP who are resistant/intolerant to ≥2 prior TKIs. This trial was registered at www.clinicaltrials.gov as #NCT03106779.Patients with chronic myeloid leukemia in chronic phase (CML-CP) resistant/intolerant to ≥2 tyrosine kinase inhibitors (TKIs) are at high risk of experiencing poor outcomes because of disease biology and inadequate efficacy and/or safety of current therapies. Asciminib, a first-in-class BCR-ABL1 inhibitor Specifically Targeting the ABL Myristoyl Pocket (STAMP), has the potential to overcome resistance/intolerance to approved TKIs. In this phase 3, open-label study, patients with CML-CP previously treated with ≥2 TKIs were randomized (2:1) to receive asciminib 40 mg twice daily vs bosutinib 500 mg once daily. Randomization was stratified by major cytogenetic response (MCyR) status at baseline. The primary objective was to compare the major molecular response (MMR) rate at week 24 for asciminib vs bosutinib. A total of 233 patients were randomized to asciminib (n = 157) or bosutinib (n = 76). Median follow-up was 14.9 months. The MMR rate at week 24 was 25.5% with asciminib and 13.2% with bosutinib. The difference in MMR rate between treatment arms, after adjusting for MCyR at baseline, was 12.2% (95% confidence interval, 2.19-22.30; 2-sided P = .029). Fewer grade ≥3 adverse events (50.6% vs 60.5%) and adverse events leading to treatment discontinuation (5.8% vs 21.1%) occurred with asciminib than with bosutinib. The study showed a superior efficacy of asciminib compared with that of bosutinib, together with a favorable safety profile. These results support the use of asciminib as a new therapy in patients with CML-CP who are resistant/intolerant to ≥2 prior TKIs. This trial was registered at www.clinicaltrials.gov as #NCT03106779. |
Author | Minami, Yosuke Voloshin, Sergey Kim, Dennis Dong Hwan Turkina, Anna Bédoucha, Véronique Fogliatto, Laura Maria Cortes, Jorge E. Lomaia, Elza Annunziata, Mario Kim, Dong-Wook Aimone, Paola Sasaki, Koji Boquimpani, Carla Quenet, Sara Abdo, Andre Chee, Lynette Mauro, Michael J. Apperley, Jane F. Chaudhri, Naeem Réa, Delphine García-Gutiérrez, Valentin Saussele, Susanne Hochhaus, Andreas Allepuz, Alex le Coutre, Philipp Hughes, Timothy P. |
Author_xml | – sequence: 1 givenname: Delphine orcidid: 0000-0001-5379-7461 surname: Réa fullname: Réa, Delphine email: delphine.rea@aphp.fr organization: DMU Hématologie, Hôpital Saint-Louis, Paris, France – sequence: 2 givenname: Michael J. orcidid: 0000-0002-2251-4032 surname: Mauro fullname: Mauro, Michael J. organization: Myeloproliferative Neoplasms Program, Memorial Sloan Kettering Cancer Center, New York, NY – sequence: 3 givenname: Carla surname: Boquimpani fullname: Boquimpani, Carla organization: HEMORIO, State Institute of Hematology Arthur de Siquiera Cavalcanti, Rio de Janeiro, Brazil – sequence: 4 givenname: Yosuke surname: Minami fullname: Minami, Yosuke organization: Department of Hematology, National Cancer Center Hospital East, Kashiwa, Japan – sequence: 5 givenname: Elza orcidid: 0000-0003-3290-7961 surname: Lomaia fullname: Lomaia, Elza organization: Institute of Oncology and Hematology, Almazov National Medical Research Centre, St Petersburg, Russia – sequence: 6 givenname: Sergey orcidid: 0000-0003-1784-0375 surname: Voloshin fullname: Voloshin, Sergey organization: Hematology and Bone Marrow Transplantation, Russian Research Institute of Hematology and Transfusiology, St Petersburg, Russia – sequence: 7 givenname: Anna surname: Turkina fullname: Turkina, Anna organization: Scientific and Advisory Department of Hemotherapy of Myeloproliferative Disorders, National Research Center for Hematology, Moscow, Russia – sequence: 8 givenname: Dong-Wook surname: Kim fullname: Kim, Dong-Wook organization: Hematologic Tumor Medicine Department, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, South Korea – sequence: 9 givenname: Jane F. orcidid: 0000-0002-1710-1794 surname: Apperley fullname: Apperley, Jane F. organization: Department of Immunology and Inflammation, Centre for Haematology Imperial College London, London, United Kingdom – sequence: 10 givenname: Andre orcidid: 0000-0002-7486-3525 surname: Abdo fullname: Abdo, Andre organization: Hemato-Oncology Department, Instituto do Câncer do Estado de São Paulo (ICESPSP), São Paulo, Brazil – sequence: 11 givenname: Laura Maria surname: Fogliatto fullname: Fogliatto, Laura Maria organization: Hematology and Hemotherapy Department, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil – sequence: 12 givenname: Dennis Dong Hwan surname: Kim fullname: Kim, Dennis Dong Hwan organization: Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada – sequence: 13 givenname: Philipp surname: le Coutre fullname: le Coutre, Philipp organization: Department of Oncology and Hematology, Charité–Universitätsmedizin Berlin, Berlin, Germany – sequence: 14 givenname: Susanne orcidid: 0000-0003-0357-5785 surname: Saussele fullname: Saussele, Susanne organization: Department of Haematology and Oncology, III. Medizinische Klinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany – sequence: 15 givenname: Mario orcidid: 0000-0001-9993-947X surname: Annunziata fullname: Annunziata, Mario organization: Division of Hematology, AORN Cardarelli, Naples, Italy – sequence: 16 givenname: Timothy P. surname: Hughes fullname: Hughes, Timothy P. organization: South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, Australia – sequence: 17 givenname: Naeem orcidid: 0000-0001-8623-1798 surname: Chaudhri fullname: Chaudhri, Naeem organization: Hematology, Stem Cell Transplant and Cellular Therapy Section, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia – sequence: 18 givenname: Koji orcidid: 0000-0002-9140-0610 surname: Sasaki fullname: Sasaki, Koji organization: Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX – sequence: 19 givenname: Lynette orcidid: 0000-0002-4250-4448 surname: Chee fullname: Chee, Lynette organization: Haematology Department, Peter MacCallum Cancer Center–The Royal Melbourne Hospital, Melbourne, Australia – sequence: 20 givenname: Valentin orcidid: 0000-0003-4752-0815 surname: García-Gutiérrez fullname: García-Gutiérrez, Valentin organization: Servicio de Hematología, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain – sequence: 21 givenname: Jorge E. surname: Cortes fullname: Cortes, Jorge E. organization: Georgia Cancer Center, Augusta, GA – sequence: 22 givenname: Paola surname: Aimone fullname: Aimone, Paola organization: Novartis Pharma AG, Basel, Switzerland – sequence: 23 givenname: Alex surname: Allepuz fullname: Allepuz, Alex organization: Novartis Pharma AG, Basel, Switzerland – sequence: 24 givenname: Sara surname: Quenet fullname: Quenet, Sara organization: Novartis Pharma AG, Basel, Switzerland – sequence: 25 givenname: Véronique surname: Bédoucha fullname: Bédoucha, Véronique organization: Novartis Pharma AG, Basel, Switzerland – sequence: 26 givenname: Andreas surname: Hochhaus fullname: Hochhaus, Andreas organization: Department of Hematology and Internal Oncology, Universitätsklinikum Jena, Jena, Germany |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34407542$$D View this record in MEDLINE/PubMed |
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Title | A phase 3, open-label, randomized study of asciminib, a STAMP inhibitor, vs bosutinib in CML after 2 or more prior TKIs |
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