Obese Patients with Chronic-Phase CML Experience Delayed Responses and Lower Response Rates to First-Line Imatinib

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(ChemotherapyAdvisor) – Elevated body mass index (BMI > 25), a suspected risk factor for chronic myeloid leukemia (CML), is also associated with delayed cytogenetic and major molecular responses among patients treated with imatinib for chronic phase (CP) CML, report authors of a study published online in Cancer Letters.

“The results suggest that CML patients with increased weight at baseline should be followed and closely monitored if treated with standard-dose imatinib front-line for a possible early switch” to nilotinib or dose optimization, reported lead author Massimo Breccia, MD, of the Department of Cellular Biotechnologies and Hematology, Sapienza University, in Rome, Italy, and coauthors.

The authors studied clinical responses to targeted therapies among 339 patients with chronic phase (CP) CML, who were treated with imatinib, and 35 patients with CP-CML who were treated with first-line nilotinib.

Compared to patients with low BMIs (<18.5), patients with increased BMI at diagnosis who received imatinib “showed a significantly longer median time to achieve complete cytogenetic response (6.8 months vs. 3.3 months; P=0.001), and a reduced rate of major molecular response (77% vs. 58%; P=0.01), which was also achieved in a longer median time (29 months vs. 14 months, P=0.01),” the authors reported.

Conversely, they noted that “no differences were revealed with respect to BMI in patients treated front-line with nilotinib,” and that patients with increased BMI acheived rapid CCyR (complete cytogenic response) and MMR (major molecular response) at a rate similar to that of patients who were underweight/normal-weight.

Dr. Breccia disclosed receiving honoraria from Novartis, which markets nilotinib as Tasigna.

Abstract

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