US intergroup study of chemotherapy plus dasatinib and allogeneic stem cell transplant in Philadelphia chromosome positive ALL by Farhad Ravandi, Megan.

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Presentation transcript:

US intergroup study of chemotherapy plus dasatinib and allogeneic stem cell transplant in Philadelphia chromosome positive ALL by Farhad Ravandi, Megan Othus, Susan M. O'Brien, Stephen J. Forman, Chul S. Ha, Jeffrey Y. C. Wong, Martin S. Tallman, Elisabeth Paietta, Janis Racevskis, Geoffrey L. Uy, Mary Horowitz, Naoko Takebe, Richard Little, Uma Borate, Partow Kebriaei, Laura Kingsbury, Hagop M. Kantarjian, Jerald P. Radich, Harry P. Erba, and Frederick R. Appelbaum BloodAdv Volume 1(3):250-259 December 27, 2016 ©2016 by American Society of Hematology

Farhad Ravandi et al. Blood Adv 2016;1:250-259 ©2016 by American Society of Hematology

Treatment regimen. Treatment regimen. (A) Original regimen. Dasatinib was administered at 100 mg daily for the first 14 days of each of the consolidation cycles. (B) Modified regimen after amendment. The dasatinib dose was modified to 70 mg orally daily continuously from course 2 onward during the consolidation cycles. MTX, methotrexate. Farhad Ravandi et al. Blood Adv 2016;1:250-259 ©2016 by American Society of Hematology

Patient disposition and response. Patient disposition and response. SCT, stem cell transplant. Farhad Ravandi et al. Blood Adv 2016;1:250-259 ©2016 by American Society of Hematology

Survival outcomes. Survival outcomes. (A) Event-free survival for the whole cohort. (B) Relapse-free survival for the whole cohort. (C) Overall survival for the whole cohort. (D) Relapse-free survival in patients with no protocol transplant in first remission. (E) Overall survival in patients with no protocol transplant in first remission. Farhad Ravandi et al. Blood Adv 2016;1:250-259 ©2016 by American Society of Hematology

Outcomes with protocol-specified HCT Outcomes with protocol-specified HCT. (A) Relapse-free survival after protocol-specified HCT. (B) Overall survival after protocol-specified HCT. (C) Relapse free survival; landmark analysis HCT versus no HCT, in favor of HCT; hazard ratio (HR) 0.42, 95% CI (0.18-0.97). Outcomes with protocol-specified HCT. (A) Relapse-free survival after protocol-specified HCT. (B) Overall survival after protocol-specified HCT. (C) Relapse free survival; landmark analysis HCT versus no HCT, in favor of HCT; hazard ratio (HR) 0.42, 95% CI (0.18-0.97). (D) Overall survival; landmark analysis HCT versus no HCT, in favor of HCT; HR 0.35, 95% CI (0.12-0.97). Farhad Ravandi et al. Blood Adv 2016;1:250-259 ©2016 by American Society of Hematology

Toxicity. Toxicity. (A) Grades 3 and 4 adverse events during induction/consolidation cycles. (B) Adverse events during maintenance cycles. GI, gastrointestinal; LFT, liver function tests; NV, nausea and vomiting. Farhad Ravandi et al. Blood Adv 2016;1:250-259 ©2016 by American Society of Hematology