Best Pract Res Clin Haematol 2016 09 20;29(3):308-313. Epub 2016 Oct 20.
Institut Bergonié, Cancer Centre, 229 cours de l'Argonne, 33076 Bordeaux, France; Laboratory of Mammary and Leukemic Oncogenesis: Genetic Diversity and Resistance to Treatment, INSERM U1218, University of Bordeaux, France. Electronic address:
Stopping tyrosine kinase inhibitor (TKI) therapy after achieving a sustained deep molecular response is an emerging treatment goal for patients with chronic myeloid leukaemia in chronic phase (CML-CP). Indeed, the feasibility of stopping TKI therapy has been confirmed in various studies. The Stop Imatinib 1 (STIM1) study has shown a consistent follow-up which allowed defining a new criterion of clinical outcome evaluation, the treatment free remission (TFR). However, announcing a definitive cure remains a challenge owing to the discovery that TKIs spare quiescent leukaemic stem cells (LSC). It is definitely known that even a patient in long-term TFR has persistent LSCs. For this reason, a "functional" cure has been defined and proposed.