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HOW PATIENTS PERCEIVE A SWITCH FROM IMATINIB TO NILOTINIB: RESULTS OF A PATIENT-CENTERED ANALYSIS
Author(s): ,
Massimo Breccia
Affiliations:
Dept Cellular Biotechnologies and Hematology-Sapienza University,Hematology,Rome,Italy
,
Federica Sorà
Affiliations:
Università Cattolica Sacro Cuore Policlinico A. Gemelli,Hematology,Rome,Italy
,
Mario Annunziata
Affiliations:
Cardarelli Hospital,Hematology,Naples,Italy
,
Maria Iovine
Affiliations:
S.Sebastiano e S.Anna Hospital,Hematology,Caserta,Italy
,
Giovanni Caocci
Affiliations:
University of Cagliari,Hematology,Cagliari,Italy
,
Luigiana Luciano
Affiliations:
University Federico II,Hematology,Naples,Italy
,
Luca Franceschini
Affiliations:
Tor Vergata University,Hematology,Rome,Italy
,
Franca Falzetti
Affiliations:
AO Perugia,Hematology,Perugia,Italy
,
Fortunato Morabito
Affiliations:
AO Cosenza,Hematology,Cosenza,Italy
,
Antonella Russo Rossi
Affiliations:
Policlinico consorziale di Bari AOU,Hematology,Bari,Italy
,
Francesca Celesti
Affiliations:
Belcolle Hospital,Hematology,Viterbo,Italy
,
Anna Rita Scortechini
Affiliations:
Ospedali riuniti Ancona,Hematology,Ancona,Italy
,
Alessandra Iurlo
Affiliations:
Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico,Hematology,Milan,Italy
,
Micaela Bergamaschi
Affiliations:
AO S. Martino,Hematology,Genova,Italy
,
Fabio Stagno
Affiliations:
Ferrarotto Hospital AOU,Hematology,Catania,Italy
,
Paolo Avanzini
Affiliations:
Arcispedale S. Maria Nuova,Hematology,Reggio Emilia,Italy
,
Massimiliano Bonifacio
Affiliations:
Policlinico Borgo Roma,Hematology,Verona,Italy
,
Gianni Binotto
Affiliations:
AO Padova,Hematology,Padova,Italy
,
Francesco Fabbiano
Affiliations:
A.O. Ospedali Riuniti Villa Sofia - Cervello,Hematology,Palermo,Italy
,
Antonella Gozzini
Affiliations:
Careggi AOU,Hematology,Florence,Italy
,
Patrizia Pregno
Affiliations:
A.O.U. Città della salute e della scienza di Torino,Hematology,Turin,Italy
,
Bruno Martino
Affiliations:
Ospedali Riuniti B.M.M,Hematology,Reggio Calabria,Italy
,
Marzia Salvucci
Affiliations:
Ospedale Santa Maria delle Croci,Hematology,Ravenna,Italy
,
Isabella Cecchini
Affiliations:
Dipartimento salute,GFK Eurisko,Milan,Italy
,
Emanuela De Santis
Affiliations:
Dipartimento salute,GFK Eurisko,Milan,Italy
,
Angelo Pennella
Affiliations:
Sapienza University,Health Psychology,Rome,Italy
,
Gianantonio Rosti
Affiliations:
Ospedale Sant'Orsola Malpighi,Hematology,Bologna,Italy
Elisabetta Abruzzese
Affiliations:
Ospedale S. Eugenio,Hematology,Rome,Italy
(Abstract release date: 05/19/16) EHA Library. Breccia M. 06/09/16; 133002; E1453 Disclosure(s): Honoraria from Novartis, Bristol Myers Squibb, Pfizer, Ariad
Dr. Massimo Breccia
Dr. Massimo Breccia
Contributions
Abstract
Abstract: E1453

Type: Eposter Presentation

Background
Despite impactful result achieved with imatinib, about 40% of patients experience treatment failure and more than 15% the persistence of long-term side effects that impaired quality of life.

Aims
To investigate how a change in TKI therapy has an impact on familiar, social and working setting of CML patients’ daily life.

Methods
A structured questionnaire was administered to patients switched to nilotinib second-line after imatinib resistance or intolerance for not less than 6 months and not more than 36 months, regardless type of response. Twenty-five Italian centers participated collecting 142 patients.

Results
There were 61% males and 39% females, median age was 57 years (range 29-91). 65% with superior scholar degree. Median time from diagnosis for the overall cohort was 8 years, with 9% diagnosed less than 4 years, 66% from >4 to <10 years and 25% for > 10 years. Sixty-one % of patients changed because of loss of efficacy  with imatinib, whereas 39% for persistence of intolerance. Median time in imatinib treatment was 5 years, whereas median time with nilotinib after switch was 2 years. Overall, the level of satisfaction was requested to nilotinib and imatinib, respectively, and 93% of nilotinib-treated patients reported high level as compared to 52% of imatinib-treated patients. Dissecting this data, nilotinib-treated population reported in particular high satisfaction for achieved response (64%), for the level of daily quality of life (33%) and for tolerability (32%). Comparing imatinib and nilotinib, the majority of patients reported an impact of therapy on daily activities: 64% with imatinib reported low productivity at work (as compared to 33% with nilotinib) with 57% of them required absences from work (as compared to 35% with nilotinib). Analysing psychological perceptions, 64% of patients treated with imatinib reported the sensation of no longer feel themselves (as compared to 33% with nilotinib), and 36% to feel uncomfortable with their families (as compared to 18% with nilotinib). Overall, after switch, more patients referred a strong improvement of approach in daily living towards disease and therapy. More common emotions requested to patients to represent actual therapy with nilotinib were “trust” (65% vs 24% with imatinib), “joy” (52% vs 4% with imatinib) and “serenity” (29% vs 10% with imatinib); indeed, referred to previous therapy with imatinib, the more common emotions reported were “worry” (52% vs 22% with nilotinib), sadness” (30% vs 6% with nilotinib). “fear” (27% vs 15% with nilotinib), “frustration” (22% vs 4% with nilotinib). After switching to nilotinib, it has been asked perceptions about a possible discontinuation: 50% of patients would discontinue due to trust in personal physician, 26% to no longer feel sick and only 18% of patients would not stop for fear to losing all benefits achieved.

Conclusion
The results of this patient-centered analysis indicating high level of satisfaction in CML patients who switch to nilotinib after previous imatinib therapy, with improvements toward social, working and familiar daily life.

Session topic: E-poster

Keyword(s): Chronic myeloid leukemia, Tyrosine kinase inhibitor
Abstract: E1453

Type: Eposter Presentation

Background
Despite impactful result achieved with imatinib, about 40% of patients experience treatment failure and more than 15% the persistence of long-term side effects that impaired quality of life.

Aims
To investigate how a change in TKI therapy has an impact on familiar, social and working setting of CML patients’ daily life.

Methods
A structured questionnaire was administered to patients switched to nilotinib second-line after imatinib resistance or intolerance for not less than 6 months and not more than 36 months, regardless type of response. Twenty-five Italian centers participated collecting 142 patients.

Results
There were 61% males and 39% females, median age was 57 years (range 29-91). 65% with superior scholar degree. Median time from diagnosis for the overall cohort was 8 years, with 9% diagnosed less than 4 years, 66% from >4 to <10 years and 25% for > 10 years. Sixty-one % of patients changed because of loss of efficacy  with imatinib, whereas 39% for persistence of intolerance. Median time in imatinib treatment was 5 years, whereas median time with nilotinib after switch was 2 years. Overall, the level of satisfaction was requested to nilotinib and imatinib, respectively, and 93% of nilotinib-treated patients reported high level as compared to 52% of imatinib-treated patients. Dissecting this data, nilotinib-treated population reported in particular high satisfaction for achieved response (64%), for the level of daily quality of life (33%) and for tolerability (32%). Comparing imatinib and nilotinib, the majority of patients reported an impact of therapy on daily activities: 64% with imatinib reported low productivity at work (as compared to 33% with nilotinib) with 57% of them required absences from work (as compared to 35% with nilotinib). Analysing psychological perceptions, 64% of patients treated with imatinib reported the sensation of no longer feel themselves (as compared to 33% with nilotinib), and 36% to feel uncomfortable with their families (as compared to 18% with nilotinib). Overall, after switch, more patients referred a strong improvement of approach in daily living towards disease and therapy. More common emotions requested to patients to represent actual therapy with nilotinib were “trust” (65% vs 24% with imatinib), “joy” (52% vs 4% with imatinib) and “serenity” (29% vs 10% with imatinib); indeed, referred to previous therapy with imatinib, the more common emotions reported were “worry” (52% vs 22% with nilotinib), sadness” (30% vs 6% with nilotinib). “fear” (27% vs 15% with nilotinib), “frustration” (22% vs 4% with nilotinib). After switching to nilotinib, it has been asked perceptions about a possible discontinuation: 50% of patients would discontinue due to trust in personal physician, 26% to no longer feel sick and only 18% of patients would not stop for fear to losing all benefits achieved.

Conclusion
The results of this patient-centered analysis indicating high level of satisfaction in CML patients who switch to nilotinib after previous imatinib therapy, with improvements toward social, working and familiar daily life.

Session topic: E-poster

Keyword(s): Chronic myeloid leukemia, Tyrosine kinase inhibitor

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