Types of second cancers during TKI therapy and their treatment
| Type of second cancer during TKI therapy . | No. of patients (n = 80)* . | CML/MPN status at time of second cancer . | Therapy given for second cancer . | Response of second cancer to therapy . | Relapse/advanced second cancer . |
|---|---|---|---|---|---|
| Prostate cancer | 12 | CMR: 2, MMR: 4, CCyR: 3, CHR: 2, AP: 1 | Surg: 2, XRT: 2, XRT+drugs: 4, drugs: 2, observe: 2 | CR: 7, unknown: 2, no change: 2, mets: 1 | Mets: 1, unknown: 2 |
| Melanoma | 10 | CMR: 2, MMR: 2, CCyR: 4, CHR: 2 | Surg: 9; surg+XRT+drugs: 1 | CR: 10 | None |
| GI cancer (colon + gastric + esophageal) | 8 (4 + 2+2) | CMR: 2, MMR: 3, CCyR: 1, CHR: 2 | Surg: 1, drugs: 1, observe: 3, surg+drugs± XRT: 3 | CR: 5, no change: 3 | None |
| GU cancer (urinary bladder+kidney) | 4 (1 + 3) | CMR: 2, CCyR: 2 | Surg: 2, observe: 1, drugs: 1 | CR: 2, no change: 1, unknown: 1 | Unknown: 1 |
| Thyroid cancer | 3 | CMR: 1, MMR: 1, CCyR: 1 | Surg | CR | None |
| Breast cancer (relapse+new†) | 4 (2 + 2) | MMR: 2, PCyR: 1, PV: 1 | Drugs: 1, drugs+XRT: 1 drugs+XRT+surg: 2 | CR: 1, unknown: 1, mets: 2 | Mets in the relapse patients: 2 |
| CLL | 2 | MMR: 1, CCyR: 1 | Observe | No change | None |
| GI cancer (hepatobiliary)† | 2 | CHR: 1, MMR: 1 | Drugs: 1, drugs+XRT: 1 | No change: 2 | Mets: 1 |
| GU cancer (ovarian + uterine) | 2 (1 + 1) | MMR: 1, CP: 1 | Surg: 1, Surg+XRT: 1 | CR: 2 | None |
| Head and neck cancer | 2 | MMR: 1, CCyR: 1 | Surg: 1, observe: 1 | CR: 1, no change: 1 | None |
| Lung cancer | 1 | CHR | Surg | CR | None |
| Lymphoma (large B cell) | 1 | CMR | Drugs+XRT | CR | None |
| MPN | 1 | CMR | Anagrelide | No change | None |
| Pancreatic cancer | 1 | CCyR | Observation | No change | Mets |
| Thymoma | 1 | MMR | Surg | CR | None |
| Cancer of unknown primary | 1 | MyBP | None | Mets | Mets to BM |
| Skin cancer (BCC/SCC) | 25 | CMR: 4, MMR: 4, CCyR: 2, PCyR: 3, CHR: 8, CP: 2, AP: 2 | Surg: 24, observe: 1 | CR: 24, no change: 1 | None |
| Type of second cancer during TKI therapy . | No. of patients (n = 80)* . | CML/MPN status at time of second cancer . | Therapy given for second cancer . | Response of second cancer to therapy . | Relapse/advanced second cancer . |
|---|---|---|---|---|---|
| Prostate cancer | 12 | CMR: 2, MMR: 4, CCyR: 3, CHR: 2, AP: 1 | Surg: 2, XRT: 2, XRT+drugs: 4, drugs: 2, observe: 2 | CR: 7, unknown: 2, no change: 2, mets: 1 | Mets: 1, unknown: 2 |
| Melanoma | 10 | CMR: 2, MMR: 2, CCyR: 4, CHR: 2 | Surg: 9; surg+XRT+drugs: 1 | CR: 10 | None |
| GI cancer (colon + gastric + esophageal) | 8 (4 + 2+2) | CMR: 2, MMR: 3, CCyR: 1, CHR: 2 | Surg: 1, drugs: 1, observe: 3, surg+drugs± XRT: 3 | CR: 5, no change: 3 | None |
| GU cancer (urinary bladder+kidney) | 4 (1 + 3) | CMR: 2, CCyR: 2 | Surg: 2, observe: 1, drugs: 1 | CR: 2, no change: 1, unknown: 1 | Unknown: 1 |
| Thyroid cancer | 3 | CMR: 1, MMR: 1, CCyR: 1 | Surg | CR | None |
| Breast cancer (relapse+new†) | 4 (2 + 2) | MMR: 2, PCyR: 1, PV: 1 | Drugs: 1, drugs+XRT: 1 drugs+XRT+surg: 2 | CR: 1, unknown: 1, mets: 2 | Mets in the relapse patients: 2 |
| CLL | 2 | MMR: 1, CCyR: 1 | Observe | No change | None |
| GI cancer (hepatobiliary)† | 2 | CHR: 1, MMR: 1 | Drugs: 1, drugs+XRT: 1 | No change: 2 | Mets: 1 |
| GU cancer (ovarian + uterine) | 2 (1 + 1) | MMR: 1, CP: 1 | Surg: 1, Surg+XRT: 1 | CR: 2 | None |
| Head and neck cancer | 2 | MMR: 1, CCyR: 1 | Surg: 1, observe: 1 | CR: 1, no change: 1 | None |
| Lung cancer | 1 | CHR | Surg | CR | None |
| Lymphoma (large B cell) | 1 | CMR | Drugs+XRT | CR | None |
| MPN | 1 | CMR | Anagrelide | No change | None |
| Pancreatic cancer | 1 | CCyR | Observation | No change | Mets |
| Thymoma | 1 | MMR | Surg | CR | None |
| Cancer of unknown primary | 1 | MyBP | None | Mets | Mets to BM |
| Skin cancer (BCC/SCC) | 25 | CMR: 4, MMR: 4, CCyR: 2, PCyR: 3, CHR: 8, CP: 2, AP: 2 | Surg: 24, observe: 1 | CR: 24, no change: 1 | None |
CMR, complete molecular response; CHR, complete hematologic response; Surg, surgery; XRT, radiation therapy; drugs, drug therapy; CR, complete remission; mets, metastasis; GI, gastrointestinal; GU, genitourinary; PCyR, partial cytogenetic response; CLL, chronic lymphocytic leukemia; and MyBP, myeloid blast phase.
Patients counted ≥ 2 times if they developed ≥ 2 second cancers
Two patients with MPN: 1 developed a new breast cancer and 1 had cholangiocarcinoma.