title: Monitoring and switching patterns of patients with chronic myeloid leukemia treated with imatinib in community settings: a chart review analysis.
abstract: OBJECTIVE
  Monitoring treatment response is an integral part of chronic myeloid leukemia (CML) treatment. The guidelines recommend regular monitoring using standard methods (e.g., real-time quantitative polymerase chain reaction based on the international scale for molecular response) and treatment adjustment when failure is detected among patients treated with imatinib. The objective of this study was to assess the real-world monitoring and therapy adjustment in this patient population in the US.
  
  
  METHODS
  Twenty-nine physicians from community practices across the US participated in an online chart review. Adult patients with chronic phase CML who initiated imatinib as first-line therapy during 2006-2010 were selected. Information was collected up to 36 months after imatinib initiation, including response monitoring, response status, and therapy adjustment upon treatment failure.
  
  
  RESULTS
  The study included 297 eligible patients. By 18 months, 47% of patients had received cytogenetic response assessment continuously as recommended by the guidelines. The corresponding proportion was 39% for continuous molecular response assessment. Among patients who experienced treatment failure by 18 months, only 14%-38% of patients switched to a second-generation tyrosine kinase inhibitor as recommended by the National Comprehensive Cancer Network and the European Leukemia Net guidelines.
  
  
  CONCLUSIONS
  Major limitations included limited generalizability and the inability to accurately assess molecular response due to the variations in testing methods during the study period.
  
  
  CONCLUSIONS
  Based on the guidelines, the rates of treatment monitoring and switching upon failure were low, demonstrating the need for improvement in CML care in community settings in the US.
authors.affiliation: Novartis Pharmaceuticals Corporation, East Hanover, NJ 07936-1080, USA. lei.chen@novartis.com
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.forename: Annie
authors.initials: A
authors.lastname: Guérin
authors.forename: Jipan
authors.initials: J
authors.lastname: Xie
authors.forename: Eric Q
authors.initials: EQ
authors.lastname: Wu
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Yu
authors.forename: Solveig G
authors.initials: SG
authors.lastname: Ericson
authors.forename: Elias
authors.initials: E
authors.lastname: Jabbour
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate