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Home > Importance of Response Milestones

Early molecular response (EMR) predicts long-term survival

EMR predicts:

  • Increased likelihood of MR4.5 response1

  • Reduced risk of progression1

  • Improved OS2

Rate of Survival
An image illustrating the rates of survival with and without EMR regardless of TKI choice.

Based on a retrospective analysis of newly diagnosed patients on TKI therapy.
EMR is defined as BCR-ABL1 ≤10% at 3 months.2

Rates of survival with and without EMR
Rates of survival with and without EMR
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Achieving MR4.5 improves prognosis and enables treatment-free response (TFR)


Sustained MR4.5 is required for treatment-free remission, an emerging treatment goal in CML4-6

Deeper responses reduce the risk for progression
An illustrative correlation of response level and leukemic disease burden

Figure is an illustrative correlation of response level and leukemic disease burden.
Range of observation time by response rate was 3.0 to 4.7 years.7

Failure to achieve MR4.5 may leave your patients at risk for disease progression.
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The journey to long-term disease control starts with TASIGNA

An image illustrating the response milestones for TASIGNA in 1L and 2L.

MR, molecular response; OS, overall survival; ELN, European LeukemiaNet; CCyR, complete cytogenetic response; MMR, major molecular response; AP, accelerated phase; BC, blast crisis.

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References: 1. Hughes TP, Saglio G, Kantarjian HM, et al. Early molecular response predicts outcomes in patients with chronic myeloid leukemia in chronic phase treated with frontline nilotinib or imatinib. Blood. 2014;123(9):1353-1360.  2. Marin D, Ibrahim AR, Lucas C, et al. Assessment of BCR-ABL1 transcript levels at 3 months is the only requirement for predicting outcome for patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors. J Clin Oncol. 2012;30(3):232-238. 3. Baccarani M, Deininger MW, Rosti G, et al. European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013. Blood. 2013;122(6):872-884. 4. Hochhaus A, Saussele S, Rosti G, et al; ESMO Guidelines Committee. Chronic myeloid leukaemia: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28(suppl 4):iv41-iv51. 5. Hochhaus A, Masszi T, Giles FJ, et al. Treatment-free remission following frontline nilotinib in patients with chronic myeloid leukemia in chronic phase: results from the ENESTfreedom study. Leukemia. 2017;31(7):1525-1531. 6. Mahon F-X, Boquimpani C, Kim D-W, et al. Treatment-free remission after second-line nilotinib treatment in patients with chronic myeloid leukemia in chronic phase: results from a single-group, phase 2, open-label study. Ann Intern Med. 2018;168(7):461-470. 7. Hehlmann R, Müller MC, Lauseker M, et al. Deep molecular response is reached by the majority of patients treated with imatinib, predicts survival, and is achieved more quickly by optimized high-dose imatinib: results from the randomized CML-Study IV. J Clin Oncol. 2014;32(5):415-423. 8. Habucky K, Duverger B, Kreft R, Kozlovsky V. TASIGNA® (nilotinib) 50 mg, 150 mg and 200 mg hard capsules core data sheet, version 1.8. West Sussex, United Kingdom: Novartis Europharm Limited; 2016:1-54. 9. Hochhaus A, Saglio G, Hughes TP, et al. Long-term benefits and risks of frontline nilotinib vs imatinib for chronic myeloid leukemia in chronic phase: 5-year update of the randomized ENESTnd trial. Leukemia. 2016;30(5):1044-1054.

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