Leukemia research · 2026
Real-world outcomes of asciminib versus first- and second-generation tyrosine kinase inhibitors as second-line treatment for chronic-phase chronic myeloid leukemia.
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Atallah Ehab L, Sadek Islam, McGovern Emily, Latremouille-Viau Dominick, Rossi Carmine, Bellefleur Remi, Gobeil Nathan, Marquez Gabriel, Guérin Annie, Yang Daisy, Wei David
Аннотация
BACKGROUND: This study compared real-world outcomes of patients with chronic myeloid leukemia in chronic phase (CML-CP) treated with asciminib and first/second generation (1 G/2 G) tyrosine kinase inhibitors (TKI) as second-line treatment (2 L) in the US.
METHODS: A retrospective panel-based chart review from oncologists/hematologists was conducted on adult patients with CML-CP in 2 L treated with asciminib or 1 G/2 G TKIs between January 2022-June 2023 (index period). Entropy balancing was used to adjust baseline characteristics between asciminib and 1 G/2 G TKI cohorts. Time to discontinuation, progression to accelerated phase/blast crisis (AP/BC), BCR::ABL1 ≤ 0.1% (MMR), and BCR::ABL1 ≤ 0.01% (MR4) post-index were assessed using weighted Kaplan-Meier analyses and Gehan-Breslow tests.
RESULTS: De-identified data on 255 patients (median age: 62.0, female: 43.5%, White: 56.1%) in the asciminib cohort were collected from 76 physicians (community/academic: 47.4/52.6%) and 233 patients (median age: 62.0, female: 43.3%, White: 56.2%) in the 1 G/2 G TKI cohort from 72 physicians (community/academic: 41.7/58.3%). By 48 weeks post-index, fewer patients in the asciminib (4.6%) versus 1 G/2 G TKI (10.4%) cohort experienced discontinuations (p = 0.07), and no patients progressed to AP/BC in the asciminib versus 4.2% in the 1 G/2 G TKI cohort (p < 0.05). By 48 weeks post-index, 68.3% of the asciminib versus 59.8% of the TKI cohort achieved or maintained MMR, and 40.6% versus 22.0% for MR4. Median time to MMR (MR4) was 30.7 (59.7) and 39.7 (72.7) weeks for the asciminib and 1 G/2 G TKI cohorts, respectively (all p < 0.05).
CONCLUSIONS: Findings from this large real-world US study suggest that 2 L asciminib offers favorable tolerability and better effectiveness compared with 1 G/2 G TKIs for patients with CML-CP.
METHODS: A retrospective panel-based chart review from oncologists/hematologists was conducted on adult patients with CML-CP in 2 L treated with asciminib or 1 G/2 G TKIs between January 2022-June 2023 (index period). Entropy balancing was used to adjust baseline characteristics between asciminib and 1 G/2 G TKI cohorts. Time to discontinuation, progression to accelerated phase/blast crisis (AP/BC), BCR::ABL1 ≤ 0.1% (MMR), and BCR::ABL1 ≤ 0.01% (MR4) post-index were assessed using weighted Kaplan-Meier analyses and Gehan-Breslow tests.
RESULTS: De-identified data on 255 patients (median age: 62.0, female: 43.5%, White: 56.1%) in the asciminib cohort were collected from 76 physicians (community/academic: 47.4/52.6%) and 233 patients (median age: 62.0, female: 43.3%, White: 56.2%) in the 1 G/2 G TKI cohort from 72 physicians (community/academic: 41.7/58.3%). By 48 weeks post-index, fewer patients in the asciminib (4.6%) versus 1 G/2 G TKI (10.4%) cohort experienced discontinuations (p = 0.07), and no patients progressed to AP/BC in the asciminib versus 4.2% in the 1 G/2 G TKI cohort (p < 0.05). By 48 weeks post-index, 68.3% of the asciminib versus 59.8% of the TKI cohort achieved or maintained MMR, and 40.6% versus 22.0% for MR4. Median time to MMR (MR4) was 30.7 (59.7) and 39.7 (72.7) weeks for the asciminib and 1 G/2 G TKI cohorts, respectively (all p < 0.05).
CONCLUSIONS: Findings from this large real-world US study suggest that 2 L asciminib offers favorable tolerability and better effectiveness compared with 1 G/2 G TKIs for patients with CML-CP.