Clinical and molecular characteristics of the 25 PACE CP-CML patients harboring compound mutations at baseline
Pt ID . | Achieved primary end point . | Time on study (d) . | Prior TKI* . | Baseline SS . | Baseline NGS . | Best response‡ . | Time to response (d) . | Response duration (d) . | PADD (mg) . | Reason discontinued . | Postbaseline SS . | ||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Mutation . | %† . | Mutation . | %† . | Mutation . | %† . | Time . | |||||||||
191 | N | 8 | I D N | V379I | 100 | V379I | 90 | None | N/A | N/A | 45 | Adverse event | V379I | 100 | EOT |
V379I/H396P | 3 | ||||||||||||||
V379I/E459K | 3 | ||||||||||||||
264 | N | 11 | I D | H396R | 100 | H396R | 88 | None | N/A | N/A | 45 | Progressive disease | Not evaluable (o postbaseline sample) | ||
H396R/V299L | 5 | ||||||||||||||
49 | N | 27 | I N D | F359C | 100 | F359C/T315I | 76 | None | N/A | N/A | 45 | Progressive disease | Not evaluable (no postbaseline sample) | ||
T315I | 90 | F359C | 12 | ||||||||||||
F359C/V299L | 9 | ||||||||||||||
263 | N | 226 | I D N | F359V | 90 | F359V | 82 | None | N/A | N/A | 35 | Progressive disease | T315I | 100 | EOT |
T315I | 3 | ||||||||||||||
F359V/E255K | 1 | ||||||||||||||
149 | N | 245 | I D | F359C | 100 | F359C/F317L | 73 | None | N/A | N/A | 31 | Adverse event | F359C | 100 | EOT |
F317L | 80 | F359C/T315I | 21 | ||||||||||||
T315I | 40 | F359C | 3 | ||||||||||||
249 | N | 840+ | I D N | Y253H | 100 | Y253H | 94 | None | N/A | N/A | 13 | Ongoing | Y253H | 10 | 1 y |
G250E/F317L | 1 | ||||||||||||||
242 | N§ | 924+ | I D N | T315I | 50 | T315I/F317L | 34 | CCyR‖ | 506 | 417+ | 43 | Ongoing | Not evaluable (no amplification)†† | 1 y | |
F317L | 40 | T315I | 1 | ||||||||||||
35 | N¶ | 1007+ | I D N | F317L | 100 | F317L/H396R | 75 | MMR | 259 | 664+ | 26 | Ongoing | Not evaluable (no amplification)†† | 1y | |
H396R | 80 | F317L/E279K | 20 | ||||||||||||
E279K | 10 | F317L/E281K | 2 | ||||||||||||
F317L | 1 | ||||||||||||||
125 | N | 1014+ | I D N | V299L | 100 | H396R/V299L | 97 | None | N/A | N/A | 27 | Ongoing | No mutation detected | 1 y | |
H396R | 100 | ||||||||||||||
262 | Y | 224 | I N D | V299L | 100 | F359V/V299L | 97 | CCyR | 83 | 1# | 26 | Progressive disease | Y253H | 100 | EOT |
F359V | 100 | F359V | 100 | ||||||||||||
247 | Y | 298 | I (D N) B | G250E | 20 | G250E | 27 | CCyR | 175 | 78 | 43 | Death | Not evaluable (no amplification)†† | ||
G250E/E279V | 1 | ||||||||||||||
115 | Y | 594 | I | T315I | 100 | T315I | 95 | MMR | 167 | 433 | 45 | Adverse event | Not evaluable (no amplification)†† | ||
T315I/I432M | 2 | ||||||||||||||
T315I/R386M | 1 | ||||||||||||||
83 | Y | 848 | I D N | F317L | 100 | F317L/E459K | 95 | MMR | 583 | 82 | 32 | Withdrawal | Not evaluable (no amplification)†† | ||
E459K | 100 | F317L | 2 | ||||||||||||
101 | Y | 875 | I D | T315I | 100 | T315I | 93 | CCyR‖ | 168 | 587 | 29 | Adverse event | Not evaluable (no amplification)†† | ||
T315I/E275D | 3 | ||||||||||||||
7 | Y | 903 | I N D | F317L | 100 | F317L/E450G | 92 | PCyR | 252 | 170 | 5 | Withdrawal | F317L/ E450G | 10 | EOT |
E450G | 90 | F359V | 6 | ||||||||||||
185 | Y | 928+ | I D N | F359I | 84 | MMR | 524 | 322+ | 43 | Ongoing | N/A** | ||||
F359I | 90 | F359I/T277I | 2 | ||||||||||||
G250E | 10 | G250E | 1 | ||||||||||||
E507G | 1 | ||||||||||||||
228 | Y | 937+ | I D | V299L | 100 | V299L | 95 | MMR | 55 | 785+ | 44 | Ongoing | N/A** | ||
V299L/P310L | 2 | ||||||||||||||
76 | Y | 944+ | I (D N) B | M244V | 100 | M244V | 89 | MMR | 85 | 841+ | 16 | Ongoing | N/A** | ||
F359V | 3 | ||||||||||||||
M244V/G250W | 2 | ||||||||||||||
234 | Y | 951+ | I D N | F359V | 100 | F359V | 91 | MMR | 336 | 576+ | 28 | Ongoing | N/A** | ||
F359V/M244V | 1 | ||||||||||||||
113 | Y | 953+ | I D N | F317L | 100 | F317L/E459K | 99 | MMR | 87 | 845+ | 45 | Ongoing | N/A** | ||
E459K | 100 | ||||||||||||||
112 | Y | 967+ | I | T315I | 100 | T315I | 92 | MMR | 81 | 842+ | 44 | Ongoing | N/A** | ||
C475W | 1 | ||||||||||||||
T315I/K262N | 1 | ||||||||||||||
89 | Y | 992+ | I N B | F359V | 60 | MMR | 84 | 832+ | 31 | Ongoing | N/A** | ||||
F359V | 90 | T315I | 29 | ||||||||||||
T315I | 20 | F359V/M237R | 2 | ||||||||||||
F359V/R362T | 2 | ||||||||||||||
36 | Y | 1012+ | I N | F317L | 100 | E459K/F317L | 98 | MMR | 168 | 762+ | 42 | Ongoing | N/A** | ||
E459K | 100 | ||||||||||||||
159 | Y | 1055+ | (D N) I | T315I | 100 | T315I | 65 | MMR | 249 | 759+ | 16 | Ongoing | N/A** | ||
T315I/M237V | 3 | ||||||||||||||
10 | Y | 1119+ | I N | Y253H | 100 | Y253H | 96 | MMR | 83 | 1016+ | 18 | Ongoing | N/A** | ||
Y253H/A287V | 1 | ||||||||||||||
Y253H/E282D | 1 | ||||||||||||||
Y456C | 1 |
Pt ID . | Achieved primary end point . | Time on study (d) . | Prior TKI* . | Baseline SS . | Baseline NGS . | Best response‡ . | Time to response (d) . | Response duration (d) . | PADD (mg) . | Reason discontinued . | Postbaseline SS . | ||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Mutation . | %† . | Mutation . | %† . | Mutation . | %† . | Time . | |||||||||
191 | N | 8 | I D N | V379I | 100 | V379I | 90 | None | N/A | N/A | 45 | Adverse event | V379I | 100 | EOT |
V379I/H396P | 3 | ||||||||||||||
V379I/E459K | 3 | ||||||||||||||
264 | N | 11 | I D | H396R | 100 | H396R | 88 | None | N/A | N/A | 45 | Progressive disease | Not evaluable (o postbaseline sample) | ||
H396R/V299L | 5 | ||||||||||||||
49 | N | 27 | I N D | F359C | 100 | F359C/T315I | 76 | None | N/A | N/A | 45 | Progressive disease | Not evaluable (no postbaseline sample) | ||
T315I | 90 | F359C | 12 | ||||||||||||
F359C/V299L | 9 | ||||||||||||||
263 | N | 226 | I D N | F359V | 90 | F359V | 82 | None | N/A | N/A | 35 | Progressive disease | T315I | 100 | EOT |
T315I | 3 | ||||||||||||||
F359V/E255K | 1 | ||||||||||||||
149 | N | 245 | I D | F359C | 100 | F359C/F317L | 73 | None | N/A | N/A | 31 | Adverse event | F359C | 100 | EOT |
F317L | 80 | F359C/T315I | 21 | ||||||||||||
T315I | 40 | F359C | 3 | ||||||||||||
249 | N | 840+ | I D N | Y253H | 100 | Y253H | 94 | None | N/A | N/A | 13 | Ongoing | Y253H | 10 | 1 y |
G250E/F317L | 1 | ||||||||||||||
242 | N§ | 924+ | I D N | T315I | 50 | T315I/F317L | 34 | CCyR‖ | 506 | 417+ | 43 | Ongoing | Not evaluable (no amplification)†† | 1 y | |
F317L | 40 | T315I | 1 | ||||||||||||
35 | N¶ | 1007+ | I D N | F317L | 100 | F317L/H396R | 75 | MMR | 259 | 664+ | 26 | Ongoing | Not evaluable (no amplification)†† | 1y | |
H396R | 80 | F317L/E279K | 20 | ||||||||||||
E279K | 10 | F317L/E281K | 2 | ||||||||||||
F317L | 1 | ||||||||||||||
125 | N | 1014+ | I D N | V299L | 100 | H396R/V299L | 97 | None | N/A | N/A | 27 | Ongoing | No mutation detected | 1 y | |
H396R | 100 | ||||||||||||||
262 | Y | 224 | I N D | V299L | 100 | F359V/V299L | 97 | CCyR | 83 | 1# | 26 | Progressive disease | Y253H | 100 | EOT |
F359V | 100 | F359V | 100 | ||||||||||||
247 | Y | 298 | I (D N) B | G250E | 20 | G250E | 27 | CCyR | 175 | 78 | 43 | Death | Not evaluable (no amplification)†† | ||
G250E/E279V | 1 | ||||||||||||||
115 | Y | 594 | I | T315I | 100 | T315I | 95 | MMR | 167 | 433 | 45 | Adverse event | Not evaluable (no amplification)†† | ||
T315I/I432M | 2 | ||||||||||||||
T315I/R386M | 1 | ||||||||||||||
83 | Y | 848 | I D N | F317L | 100 | F317L/E459K | 95 | MMR | 583 | 82 | 32 | Withdrawal | Not evaluable (no amplification)†† | ||
E459K | 100 | F317L | 2 | ||||||||||||
101 | Y | 875 | I D | T315I | 100 | T315I | 93 | CCyR‖ | 168 | 587 | 29 | Adverse event | Not evaluable (no amplification)†† | ||
T315I/E275D | 3 | ||||||||||||||
7 | Y | 903 | I N D | F317L | 100 | F317L/E450G | 92 | PCyR | 252 | 170 | 5 | Withdrawal | F317L/ E450G | 10 | EOT |
E450G | 90 | F359V | 6 | ||||||||||||
185 | Y | 928+ | I D N | F359I | 84 | MMR | 524 | 322+ | 43 | Ongoing | N/A** | ||||
F359I | 90 | F359I/T277I | 2 | ||||||||||||
G250E | 10 | G250E | 1 | ||||||||||||
E507G | 1 | ||||||||||||||
228 | Y | 937+ | I D | V299L | 100 | V299L | 95 | MMR | 55 | 785+ | 44 | Ongoing | N/A** | ||
V299L/P310L | 2 | ||||||||||||||
76 | Y | 944+ | I (D N) B | M244V | 100 | M244V | 89 | MMR | 85 | 841+ | 16 | Ongoing | N/A** | ||
F359V | 3 | ||||||||||||||
M244V/G250W | 2 | ||||||||||||||
234 | Y | 951+ | I D N | F359V | 100 | F359V | 91 | MMR | 336 | 576+ | 28 | Ongoing | N/A** | ||
F359V/M244V | 1 | ||||||||||||||
113 | Y | 953+ | I D N | F317L | 100 | F317L/E459K | 99 | MMR | 87 | 845+ | 45 | Ongoing | N/A** | ||
E459K | 100 | ||||||||||||||
112 | Y | 967+ | I | T315I | 100 | T315I | 92 | MMR | 81 | 842+ | 44 | Ongoing | N/A** | ||
C475W | 1 | ||||||||||||||
T315I/K262N | 1 | ||||||||||||||
89 | Y | 992+ | I N B | F359V | 60 | MMR | 84 | 832+ | 31 | Ongoing | N/A** | ||||
F359V | 90 | T315I | 29 | ||||||||||||
T315I | 20 | F359V/M237R | 2 | ||||||||||||
F359V/R362T | 2 | ||||||||||||||
36 | Y | 1012+ | I N | F317L | 100 | E459K/F317L | 98 | MMR | 168 | 762+ | 42 | Ongoing | N/A** | ||
E459K | 100 | ||||||||||||||
159 | Y | 1055+ | (D N) I | T315I | 100 | T315I | 65 | MMR | 249 | 759+ | 16 | Ongoing | N/A** | ||
T315I/M237V | 3 | ||||||||||||||
10 | Y | 1119+ | I N | Y253H | 100 | Y253H | 96 | MMR | 83 | 1016+ | 18 | Ongoing | N/A** | ||
Y253H/A287V | 1 | ||||||||||||||
Y253H/E282D | 1 | ||||||||||||||
Y456C | 1 |
B, bosutinib; CCyR, complete cytogenetic response; D, dasatinib; EOT, end of treatment; I, imatinib; MMR, major molecular response; N, nilotinib; N/A, not applicable; PADD, ponatinib average daily dose; PCyR, partial cytogenetic response; Pt, patient; TKI, tyrosine kinase inhibitor.
Patients who did not achieve the primary end point are listed first, with each subgroup then arranged by time on study. Bold font denotes exact or alternate (also underlined) substitutions at amino acids previously associated with TKI resistance4 ; nonbolded font denotes substitutions at amino acids not previously associated with TKI resistance.
The order of TKIs from left to right indicates the sequence of TKI treatment in the patient’s history (first to last); parentheses indicate that the treatment order is unknown.
The percentage indicates the mutation allele frequency in the patient sample.
Best response does not include hematologic response.
Cytogenetic response for this patient was only assessed at 9 months (no MCyR) and 18 months (CCyR).
In this patient, MMR was achieved at 9 months; however, cytogenetic response was not assessed between months 3 and 12; SS was conducted at 1 year and no amplification of the transcript was achieved.
Patients with atypical transcripts in whom molecular response could not be assessed.
1-day duration indicates patient had one assessment at which criteria for response were met and no further evaluable cytogenetic assessments.
Postbaseline mutation status was not evaluated for patients who achieved and remain on study in continuous MCyR.
Patients are in CCyR and/or <1% BCR-ABL1 transcript levels at the time of sample analysis.