ESH CML/MPN 2025 | An overview of a session on treatment optimization in CML

I found this session particularly interesting because what we heard, not only my topic like dose de-escalation before TFR, before attempting TFR, but also dose optimization in general presented by Tim Brümmendorf and also introduced by Professor Hochhaus in another session who presented a very important trial, I mean randomized trial, DasaHiT about the dose optimization from the very beginning, I mean in the frontline setting. So dose optimization but not only this part. 

Also we discussed a combination of treatments that it was a great talk given by Professor Entz, who presented data from the FAsciNation trial, for instance, combining drugs with different mechanisms of action, asciminib and ATP competitive TKIs, but we still do not know when, which doses, when we should implement the dose reduction. So still many questions remain open, and I think that it was like a consensus that we need more trials and more evidence to establish some rules for such an important direction like treatment optimization. 

But I would like, I don’t want to forget about, it was also a very very nice talk presented by Fausto Castagnetti about quality of life which is also a very very important aspect of CML patient therapy also discussed during the keynote introductory lecture led by Professor Efficace at the beginning of the conference. So I mean the key point is that we have options, we have increasing possibilities, but what we need is to establish some rules, and we still need more work on it.

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