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Meta-analysis Compares Front-Line Treatments in Newly Diagnosed Chronic-Phase CML

By: Hillary Ojeda
Posted: Thursday, October 17, 2019

According to an update network meta-analysis conducted by Yu Hu, MD, PhD, of the Huazhong University of Science and Technology, China, and colleagues, tyrosine kinase inhibitors improved responses for patients with newly diagnosed chronic phase chronic myeloid leukemia (CML) when compared with other interventions. With their results published in the journal BMC Cancer, the study authors suggest monitoring adverse events to ensure the best clinical outcomes.

“To our knowledge, this was the first [study] to comprehensively assess the comparative efficacy and tolerability of almost all front-line treatments for newly diagnosed chronic phase chronic myeloid leukemia patients,” the authors concluded.

Included in the analysis were a total of 21 randomized controlled trials with 10,187 patients; it compared 15 different types of therapy for chronic phase CML. The authors determined which patients reached major molecular response and complete cytogenetic response within 12 months and used them as primary outcomes. Cluster analysis of the treatments was performed to determine the differing levels of efficacy and tolerability. The standard treatment (imatinib 400 mg daily) was used as a comparison for all other treatments.

Nilotinib (300/400 mg twice daily), dasatinib (100 mg daily), and radotinib (300 mg twice daily) yielded the highest rates of efficacy and tolerability among the treatments. Conventionally used drugs such as newer tyrosine kinase inhibitors resulted in lower levels of efficacy than standard-dose imatinib. Interferon-α and cytarabine were associated with lower efficacy rates, for example. Additionally, high-dose therapies seemed to serve best for patients in accelerated phase/blast phase or with a suboptimal response in chronic phase CML.

Disclosure: The study authors disclosure can be found at bmccancer.biomedcentral.com.



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