Evidence map›Paper›PMID 34768161›Full record

Trial reportLeukemia research2021

A randomized, phase II trial of adjuvant immunotherapy with durable TKI-free survival in patients with chronic phase CML.

Jonathan A Webster, Tara M Robinson, Amanda L Blackford, Erica Warlick, Anna Ferguson, Ivan Borrello, Marianna Zahurak, Richard J Jones, B Douglas Smith

Open access · greenAbstract readClinical Trial, Phase IIRandomized Controlled Trial
In one paragraph

Trial report in Leukemia research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.6field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Jonathan A WebsterHematologic Malignancies and Bone Marrow Transplantation Program, Department of Oncology, Johns Hopkins University School of MedIcine, Baltimore, MD, United States. Electronic address: jwebst17@jhmi.edu.
Tara M RobinsonBioMarin, San Rafael, CA, United States.
Amanda L BlackfordDivision of Biostatistics and Bioinformatics, Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Erica WarlickDivision of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, United States.
Anna FergusonHematologic Malignancies and Bone Marrow Transplantation Program, Department of Oncology, Johns Hopkins University School of MedIcine, Baltimore, MD, United States.
Ivan BorrelloHematologic Malignancies and Bone Marrow Transplantation Program, Department of Oncology, Johns Hopkins University School of MedIcine, Baltimore, MD, United States.
Marianna ZahurakDivision of Biostatistics and Bioinformatics, Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Richard J JonesHematologic Malignancies and Bone Marrow Transplantation Program, Department of Oncology, Johns Hopkins University School of MedIcine, Baltimore, MD, United States.
B Douglas SmithHematologic Malignancies and Bone Marrow Transplantation Program, Department of Oncology, Johns Hopkins University School of MedIcine, Baltimore, MD, United States.
Johns Hopkins University · USBioMarin (United States) · USUniversity of Minnesota · US

Funding

Translational Research Central ServicesP30CA006973 · NCI · JOHNS HOPKINS UNIVERSITY · PI WILLIAM George NELSON · 1985 to 2026
$208.6M
Targeting MRDP01CA225618 · NCI · JOHNS HOPKINS UNIVERSITY · PI Catherine M. Bollard, KENNETH R COOKE · 2019 to 2026
$15.1M
NCI NIH HHS P01 CA225618NCI NIH HHS P30 CA006973
6 · The paper itself

Abstract

purposeChronic myeloid leukemia (CP-CML) patients can achieve undetectable minimal residual disease (UMRD) and discontinue tyrosine kinase inhibitors (TKIs). Cellular immunity plays an important role in CML disease control. We conducted a randomized, non-blinded phase II trial of adjuvant immunotherapy with TKIs to facilitate TKI discontinuation.

methodsTKI-treated patients with CP-CML were randomized to receive the K562/GM-CSF vaccine (vaccine) OR Interferon-α + Sargramostim (IFN). If UMRD was achieved, then all treatment was stopped. Patients who did not achieve UMRD within one year, had a molecular relapse, or discontinued therapy for toxicity could crossover.

resultsThirty-four patients were randomized to IFN (n = 18) or vaccine (n = 16), and 21 patients crossed over (IFN⟶vaccine: n = 9, vaccine⟶IFN, n = 12). TKIs at enrollment included imatinib (n = 31), nilotinib (n = 2), and dasatinib (n = 1). No patients discontinued vaccine due to side effects, while 33 % of IFN-treated patients discontinued treatment. More patients randomized to IFN (47.4 %, 95 % CI: 16.7-66.7 %) versus vaccine (25.0 %, 95 % CI: 0.5-43.5 %) achieved UMRD within one year. Seven patients randomized to IFN discontinued treatment with 28.6 % (95 % CI: 8.9-92.2 %) sustaining treatment-free remission (TFR) at 1 year, while three patients randomized to vaccine discontinued treatment with none sustaining TFR. Including crossover, there was a cumulative discontinuation success rate of 36.4 % (95 % CI: 16.6 %-79.5 %) after adjuvant IFN. Patients who sustained TFR received a median of 29 months of imatinib prior to discontinuation.

conclusionAdjuvant IFN led to durable TFRs with limited prior TKI exposure with comparable success to prior discontinuation trials, but many patients stopped IFN early.

Indexed as

Adjuvants, ImmunologicAdultAgedAntineoplastic Combined Chemotherapy ProtocolsCancer VaccinesCross-Over StudiesDasatinibFemaleFollow-Up StudiesHumansImatinib MesylateImmunotherapyInterferonsLeukemia, Myeloid, Chronic-PhaseMaleMiddle AgedAdjuvants, ImmunologicCancer VaccinesDasatinibImatinib MesylateInterferonsnilotinibPyrimidinesChronic myeloid leukemiaImatinibImmunotherapyRandomized trialTKI discontinuationVaccine

Identifiers

PMID34768161
PMCPMC8643330
OpenAlexW3209701332

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.