Chronic Myeloid Leukemia Coverage from Every Angle
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Italian Study on Use of Second-Generation TKIs as Front-Line Therapies in CML

By: Joshua D. Madera, MS
Posted: Tuesday, June 30, 2020

Treatment discontinuation with front-line second-generation tyrosine kinase inhibitors (TKIs; dasatinib and nilotinib) was relatively uncommon in patients with chronic myeloid leukemia (CML), according to a retrospective study of approximately 2,000 individuals from a registry of the Italian Medicines Agency, published in Cancer Medicine. According to Pierluigi Russo, MD, PhD, of the Italian Medicines Agency, Rome, and colleagues, “these data provide the first report on the frequency of discontinuation of front-line second-generation tyrosine kinase inhibitors and on the main causes and pattern of choice to a second-line therapy in the real-life setting.”

From 2013 to 2018, 2,420 patients with newly diagnosed chronic phase CML were enrolled in the study. Patients were recruited from the Italian Medicines Agency registries. All patients were treated with dasatinib (n = 964) and nilotinib (n = 1,456). Dr. Russo and colleagues aimed to determine the efficacy of second-generation TKIs in patients with CML based on changes to second-line treatment regimens.

The investigators found that 13.2% of patients treated with dasatinib (16.3%) and nilotinib (11.3%) needed a second-line therapy. Patients receiving dasatinib adjusted their treatment regimen due to treatment failure (39.4%) and intolerance (36.3%), as compared with 45.7% and 27.4% for those treated with nilotinib, respectively. Additionally, treatment adjustment due to resistance occurred after 293 days, whereas adjustment due to intolerance occurred after 317 days. Furthermore, 43.2% of patients who experienced resistance and/or intolerance to dasatinib were administered ponatinib as an alternative treatment, whereas 53.8% of patients receiving nilotinib were given dasatinib as an alternative therapy.

Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com.



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