Abstract：
The achievement of treatment-free remission (TFR) has become a significant clinical end-point in the management of patients with chronic myeloid leukaemia (CML), providing an opportunity to discontinue therapy with tyrosine kinase inhibitors (TKIs) while maintaining deep molecular response (DMR). Early studies, such as the French STIM trial, have demonstrated that a portion of patients can maintain DMR after treatment cessation, with rates ranging from 40% to 50%, and most relapses occurring within the first 6 months. Key prognostic factors for successful TFR, including treatment duration, duration of DMR, risk scores, and transcript type, have been identified. Optimal patient selection for TFR remains a challenge, but recent research provides insights into potential strategies to increase TFR eligibility. Evidence suggests that early intervention switching to achieve optimal response, treatment combinations, proactive switch in the case of absence of DMR, dose-optimization and induction-maintenance approach can improve molecular responses and, consequently, enhance TFR eligibility. In this review, we report and discuss all the potential therapeutic strategies that may enhance eligibility for a first attempt at TFR, with a particular emphasis on potential future approaches.
摘要：
实现无治疗缓解（TFR）已成为治疗慢性粒细胞白血病（CML）患者的重要临床终点，提供停止酪氨酸激酶抑制剂（TKIs）治疗的机会，同时维持深层分子反应（DMR）。早期研究,比如法国的STIM审判，已经证明一部分患者在治疗停止后可以维持DMR，比率从40%到50%不等，大多数复发发生在前6个月内。成功TFR的关键预后因素，包括治疗持续时间，DMR的持续时间,风险评分，和成绩单类型，已被确认。TFR的最佳患者选择仍然是一个挑战，但最近的研究提供了对提高TFR资格的潜在策略的见解。证据表明，早期干预切换以达到最佳反应，治疗组合，在没有DMR的情况下主动切换，剂量优化和诱导维持方法可以改善分子反应，因此,提高TFR资格。在这次审查中,我们报告并讨论了所有可能提高TFR首次尝试资格的潜在治疗策略，特别强调潜在的未来方法。
