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Selected research from leading health care experts whose findings have a direct bearing on public policies effecting medical progress. Research is chosen based on its quality and relevance by the Medical Progress Today editorial staff.

Selected Research

Five-Year Data on Imatinib Show Best-Ever Survival With Chronic Myeloid Leukemia
Medscape, 12-6-06

This article, reporting findings from this week's issue of the New England Journal of Medicine, shows that survival rates for patients with Chronic Myeloid Leukemia, or CML, have reached an all time high thanks to the use if the targeted cancer drug, Gleevec.

Data from the 5-year follow-up of patients taking imatinib (Gleevec, Novartis) for chronic myeloid leukemia (CML), published in the December 7 issue of the New England Journalof Medicine, show the best–ever survival with this disease.

"The 5–year estimated overall survival rate for patients who received imatinib as initial therapy (89%) is higher than that reported in any previously published prospective study of the treatment of CML," the authors write. Lead author Brian Drucker, MD, from the Oregon Health & Science University Cancer Institute, in Portland, had previously commented to Medscape that "imatinib has revolutionized the treatment of CML," pointing out that in the past 5-year survival rates were around 50%.

Previously, the most successful therapy was the combination of interferon–alpha and cytarabine, and 2 trials conducted before imatinib was available showed 5–year survival rates of 68% and 70%. Use of these historical comparisons shows a survival advantage for imatinib, the authors comment.

The 5–year data come from a study that evolved into a long–term follow–up, the team explains. Originally, the study had compared imatinib with interferon-alfa plus cytarabine (with 553 patients in each group). However, when the superiority of imatinib was demonstrated at a median 19 months of follow–up, a large proportion of patients on in the other group switched over, while others left the study after imatinib was approved by the FDA

"These results are very reassuring in that 72% of the original patients randomized to imatinib remain on therapy, " Dr. Stone commented. "Second, 82% of patients achieved a complete cryogenic response, and virtually all achieved a complete hematological response. Progression to accelerated and blast phase occurred in only 7% of the patients, with the progression rate actually decreasing over time."

"Front–line therapy with imatinib 400 mg orally daily is now the standard of care for newly diagnosed patients with CML," Dr. Stone concluded. "Long–term tolerance is good, and allogenic stem-–ell transplantation should be reserved for extremely young patients and/or those who fail to respond well to imatinib."



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