Chronic Myeloid Leukemia: De-Escalation of TKI Therapy

The feasibility of dose de-escalation of tyrosine kinase inhibitor (TKI) therapy (with close monitoring after achievement of optimal responses) has been demonstrated in clinical studies as an appropriate strategy for the prevention and management of long-term treatment-emergent adverse events (TEAEs). Clinical studies that have evaluated the de-escalation of TKI therapy have used strict eligibility criteria and more frequent molecular monitoring to ascertain the safety and efficacy of TKI de-escalation. Clinicians should be aware of the various strategies that are being evaluated in clinical trials to mitigate the risk of TEAEs associated with TKI therapy.

Target Audience

This activity is designed to meet the educational needs of oncologists, hematologists, nurse practitioners, nurses, pharmacists, physician associates, and other health care professionals who manage patients with hematologic malignancies.

Learning Objectives

  • Outline the criteria used in clinical trials that have evaluated dose de-escalation of TKI therapy.
  • Develop a treatment plan for patients with CML, incorporating dose de-escalation strategies in the appropriately selected patient population.

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Archived NCCN Tumor Boards: Optimizing Treatment of Chronic Phase Chronic Myeloid Leukemia
In the majority of patients with chronic myeloid leukemia (CML) responding to treatment, tyrosine kinase inhibitor (TKI) therapy has to be continued indefinitely, as long as patients are receiving clinical benefit. Adherence to TKI therapy is critical to achieving optimal responses, and the high-cost of TKIs can limit their long-term use and could potentially be a barrier to adherence to therapy.
Additional information
Supporters: 

Supported by educational grants from:

  • AstraZeneca
  • BeOne
  • Blueprint Medicines, a Sanofi company
  • Bristol Myers Squibb
  • Johnson & Johnson
  • Novartis
  • PharmaEssentia

Supported by an independent medical education grant from AbbVie.

This activity is supported through an independent educational grant from Merck & Co., Inc., Rahway, NJ, USA.

Course summary

Available credit: 
  • 0.50 AAPA Category 1 CME credit
  • 0.50 ACPE contact hours
  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 ANCC contact hours
    • 0.50 ANCC Pharmacology Contact Hours
  • 0.50 Participation
Course opens: 
11/02/2026
Course expires: 
11/01/2027
Part of: 
Recorded Presentations from the NCCN 2026 Annual Congress: Hematologic Malignancies™
Presenter
Vivian G. Oehler, MD
Fred Hutchinson Cancer Center
NCCN Continuing Education Disclosure Policy
It is the policy of NCCN that all planners, faculty, moderators, authors, reviewers and anyone involved in the planning and delivery of NCCN continuing education activities are expected to disclose ALL financial relationships they have had in the past 24 months with ineligible companies. The ACCME Standards for Integrity and Independence require that individuals who refuse to provide this information will be disqualified from involvement in the planning and implementation of accredited continuing education presented by NCCN. NCCN identifies, mitigates and discloses to learners all relevant financial relationships.
 
In addition, all content has been reviewed to ensure education promotes safe, effective patient care and does not promote the products or services of an ineligible company. Content, including any presentation of therapeutic options, is fair, balanced, evidence-based, scientifically accurate, and free of commercial bias and marketing. 
 
Definitions  
Ineligible Company: An ineligible company is any entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. 
Relevant Financial Relationships: Financial relationships of any dollar amount occurring within the past 24 months are defined as relevant if the educational content an individual can control is related to the business lines or products of an ineligible company. There is no minimum financial threshold. We ask for disclosure of ALL financial relationships with ineligible companies, regardless of the amount and regardless of the potential relevance of each relationship to the education.
 
Faculty Disclaimers
All faculty for this continuing education activity are competent in the subject matter and qualified by experience, training, and/or preparation for the tasks and methods of delivery. Faculty presentations may include discussion of off-label use. Faculty will disclose that the use in question is not currently approved by the FDA per the product labeling or marketing.
 
Faculty Disclosures
The faculty listed below have the following relevant financial relationships with ineligible companies to disclose. All of the relevant financial relationships listed for these individuals have been mitigated. 
 
Vivian G. Oehler, MD
Novartis Pharmaceuticals Corporation: Consulting Fee
Terns Pharmaceuticals, Inc.: Consulting Fee
Pfizer Inc.: Grant/Research Support
Takeda Pharmaceuticals North America, Inc.: Consulting Fee
 
Andrew D. Zelenetz, MD, PhD (Congress Chair and Moderator)
AbbVie, Inc.: Consulting Fee
Arvinas, Inc.: Grant/Research Support
AstraZeneca Pharmaceuticals LP: Consulting Fee
BeiGene: Consulting Fee; Grant/Research Support
Bristol Myers Squibb / Celgene Corporation / Juno Therapeutics, Inc.: Scientific Advisor
Curio Science: Consulting Fee
DAVA Oncology LP: Consulting Fee
Lilly: Consulting Fee
Genentech, Inc. / Roche: Consulting Fee; Grant/Research Support
Gilead Sciences, Inc. (Kite Pharma): Consulting Fee
GSK: Grant/Research Support
Ipsen: Consulting Fee
MEI Pharma Inc.: Consulting Fee
Pharmacyclics: Grant/Research Support
 
NCCN Staff Disclosures
None of the other planners for this educational activity have relevant financial relationships to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
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In support of improving patient care, National Comprehensive Cancer Network (NCCN) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Physicians
NCCN designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses
NCCN designates this educational activity for a maximum of 0.5 contact hour. This activity offers 0.5 pharmacotherapeutic contact hour for nurses.

Pharmacists
NCCN designates this knowledge-based continuing education activity for 0.5 contact hour (0.05 CEUs) of continuing education credit. UAN: JA4008196-0000-26-091-H01-P

Physician Associates
NCCN has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 0.5 AAPA Category 1 CME credit. Approval is valid until November 1, 2027. PAs should only claim credit commensurate with the extent of their participation.

American Board of Internal Medicine Maintenance of Certification (MOC)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 0.5 MOC point in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
 
Aggregated participant data will be shared with the commercial supporters of this activity.
American Board of Pathology Continuing Certification (CC)
This activity has been registered to offer credit in the American Board of Pathology’s (ABPath) Continuing Certification program. Successful completion of this CME activity enables the participant to earn 0.5 Lifelong Learning (Part II) credit.
 
Aggregated participant data will be shared with the commercial supporters of this activity.
American Board of Medical Specialties Maintenance of Certification (MOC)
Through the American Board of Medical Specialties (“ABMS”) ongoing commitment to increase access to practice relevant Continuing Certification Activities through the ABMS Continuing Certification Directory, NCCN 2026 Hematologic Malignancies Congress has met the requirements as a Lifelong Learning CME Activity (apply toward general CME requirement) for the following ABMS Member Boards: 
 
ABMS Lifelong Learning CME Activity
Radiology
 
Permission to Upload Credits
For ABIM, ABPath, and ABS MOC points, your information will be shared with your board through NCCN's Joint Accreditation Program and Activity Reporting System (JA-PARS). Please allow 6-8 weeks for your MOC points to appear on your board records. By sharing your Diplomate Board ID # and DOB, you are giving NCCN permission to use this information/data to report your participation to these boards via JA-PARS.

Available Credit

  • 0.50 AAPA Category 1 CME credit
  • 0.50 ACPE contact hours
  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 ANCC contact hours
    • 0.50 ANCC Pharmacology Contact Hours
  • 0.50 Participation
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Required Hardware/software

To complete this activity, users will need:

  • A device with an Internet connection and sound playback capability (speakers or a headset)
  • Adobe Reader or other PDF reader software for certificate viewing/printing