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Perspectives
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Korean J Med. 2026;101(5):221-225. Published online October 1, 2026.
DOI: https://doi.org/10.3904/kjm.2026.101.5.221
- 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
- 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
- Corresponding author: Sang Kyun Sohn ,Tel: +82-53-420-5587, Fax: +82-53-420-5587, Email: sksohn@knu.ac.kr
- Received: March 19, 2026; Revised: May 21, 2026 Accepted: June 22, 2026.
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߽ɾ :만성 골수성 백혈병; BCR-ABL 양성; 애쉬미닙; 관해 유도; 의료정책
- Abstract
- 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.
Keywords :Leukemia, myelogenous, chronic, BCR::ABL positive, Asciminib, Remission induction, Health policy
