With weekly irinotecan and docetaxel, which proved to be feasible, only 12.5% of the patients achieved major remissions, but the study was designed to obtain a response rate of at least 15.0%.
However, this result correlates well with previous chemotherapy trials that have reported response rates of 6 and 0%, respectively, in patients with pretreated oesophageal cancer (Conroy et al, 1996, Heath et al, 2002) and clearly indicates the small likelihood of major remissions in cisplatin-pretreated oesophageal cancer patients.
Older patients on IM800 achieved major molecular remission and deep molecular remission as fast as younger patients, in contrast to standard dose imatinib with which older patients achieved remissions much later than younger patients.
Achieving a major molecular remission has been associated with durable remission rates, and is a goal of current oral TKI-based CML therapy. 1, 36 A failure to obtain a major molecular remission within 18 months of treatment indicates a suboptimal response.
In a five-year follow-up study of alcohol-dependent patients with major depression, remission of alcoholism strongly and significantly increased the chances of remission of depression [ 52].
The standard dose of imatinib 400 mg daily produced a major molecular remission in 46% of patients at 12 months, whereas imatinib 800 mg daily led to a major molecular remission in 54% of patients.
At 6 months, 60% (12/20 patients) achieved a major molecular remission.
The rates of major molecular remission also favored dasatinib (83% versus 72%; P = 0.001).
At 12 months, 81% of patients had achieved a major molecular remission.
Given the differences in major molecular remission (see Table 2) between nilotinib and imatinib in updated ENESTnd data, it will be interesting to evaluate overall survival in those patients which achieved a major molecular remission.
