| Paradigm Shifts in the Management of Chronic Myeloid Leukemia and Health Policy Challenges in the Era of High Cost Anticancer Drugs |
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Sang Kyun Sohn |
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Department of Hematology-Oncology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea |
| 고가 표적 항암제 시대에 국내 만성 골수성 백혈병 치료 접근과 의료정책적 과제 |
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손상균 |
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경북대학교 의과대학 경북대학교병원 혈액종양내과 |
Correspondence:
Sang Kyun Sohn, Tel: +82-53-420-5587, Fax: +82-53-420-5587, Email: sksohn@knu.ac.kr
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Received: 19 March 2026 • Revised: 21 May 2026 • Accepted: 22 June 2026 |
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| Abstract |
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Chronic myeloid leukemia (CML) therapy has evolved from survival-oriented management into the pursuit of a “functional cure,” characterized by treatment-free remission (TFR). Achieving a deep molecular response (DMR) is a critical prerequisite for TFR and recent clinical advances have introduced novel therapeutic options that enable this goal to be reached more efficiently. asciminib, the firstin- class specifically targeting the ABL myristoyl pocket inhibitor, has demonstrated superior efficacy compared to conventional ATPcompetitive tyrosine kinase inhibitors (TKIs). In a pivotal phase 3 ASC4FIRST trial, asciminib showed significantly higher rates of major molecular response (MMR) and DMR (MR4) compared to investigator-selected TKIs. Furthermore, the early molecular response (EMR) rate was 89.6% at 12 weeks. Such rapid and sustained molecular responses are known to be predictors for successful TFR. A successful TFR improves patient quality of life by eliminating drug-related toxicities and leads to a structural reduction in long-term socioeconomic healthcare costs. This study evaluated the clinical impact of these new therapeutic paradigms. It also highlights the need to standardize high-sensitivity molecular monitoring and reform the reimbursement guidelines to support the safe implementation of TFR in Korea. |
| Key Words:
Leukemia, myelogenous, chronic, BCR::ABL positive; Asciminib; Remission induction; Health policy |
| 주제어:
만성 골수성 백혈병; BCR-ABL 양성; 애쉬미닙; 관해 유도; 의료정책 |
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