Efficacy and safety of flumatinib in the treatment of newly diagnosed chronic myeloid leukemia in the chronic phase: A real-world single-center retrospective study, with a focus on premature drug discontinuation

Mingshan Sun; Shijie Li; Zhenyi Liu; Sai Ma; Xiaohan Liu; Qing Meng; Yueyue Zheng; Chunyan Chen

doi:10.1016/j.leukres.2024.107507

Efficacy and safety of flumatinib in the treatment of newly diagnosed chronic myeloid leukemia in the chronic phase: A real-world single-center retrospective study, with a focus on premature drug discontinuation

Leuk Res. 2024 Apr 26:142:107507. doi: 10.1016/j.leukres.2024.107507. Online ahead of print.

Authors

Mingshan Sun¹, Shijie Li¹, Zhenyi Liu¹, Sai Ma¹, Xiaohan Liu¹, Qing Meng¹, Yueyue Zheng¹, Chunyan Chen²

Affiliations

¹ Qilu Hospital of Shandong University, Department of Hematology, Jinan, Shandong, China.
² Qilu Hospital of Shandong University, Department of Hematology, Jinan, Shandong, China. Electronic address: chency@sdu.edu.cn.

PMID: 38692191
DOI: 10.1016/j.leukres.2024.107507

Abstract

Purpose: To assess the real-world efficacy and safety of flumatinib as first-line and post-line treatments for chronic myeloid leukemia in the chronic phase (CML-CP).

Results: Among 141 patients receiving flumatinib as first-line and post-line treatment, the 12-month major molecular response (MMR) rates were 69.4% and 67.6%, respectively. The median time to response was 6 and 10.5 months, respectively. In post-line treatment, the early molecular response (EMR) of flumatinib as second-line is significantly superior to that of third-line treatment (3-month EMR rate: 79.2% vs. 39.3%, P<0.001; 3-month MMR rate: 45.8% vs. 21.4%, P=0.033). Contrastively, patients who switched to flumatinib due to intolerance had significantly higher MMR rates at 3, 6, and 12 months compared to patients who switched due to inadequate response (60.6% vs. 24.2%, P=0.003; 66.7% vs. 36.0%, P=0.027; 84.2% vs. 50.0%, P=0.038). Premature drug discontinuation was observed in 28.4% of the patients. Grades 3-4 hematologic adverse events (AEs) were identified as independent risk factors for premature drug discontinuation. Patients who discontinued treatment and those who previously received only imatinib therapy had a poorer molecular response and failure-free survival.

Conclusions: Flumatinib demonstrates favorable efficacy and safety. Treatment discontinuation can result in a poorer molecular response and long-term prognosis.

Keywords: Chronic myeloid leukemia; Flumatinib; Premature discontinuation; Tyrosine kinase inhibitor.