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Long-Term Benefits and Toxicity of Dasatinib in Imatinib-Resistant CML

By: Kayci Reyer
Posted: Friday, November 20, 2020

According to research published in Leukemia & Lymphoma, second-line dasatinib treatment may result in long-term benefits for patients with chronic myeloid leukemia (CML). Jiri Mayer, MD, PhD, of Masaryk University in the Czech Republic, and colleagues also found that dasatinib was tolerable even throughout multiyear therapy.

The retrospective analysis included 118 patients with chronic-phase CML who had undergone second-line dasatinib following resistance to (74%, n = 87), intolerance of (20%, n = 24), or both resistance to and intolerance of (6%, n = 7) first-line imatinib. At a median follow-up of 37 months, the estimated 5-year overall and event-free survival rates were 86% and 83%, respectively. Patients with a BCR-ABL1 transcript level of no more than 10% at the 3-month mark experienced substantially superior overall and event-free survival rates. A total of 78% of patients were estimated to achieve a complete cytogenetic response, and 68% were expected to achieve a major molecular response within 5 years.

By a median of 21 months, almost half of the patients enrolled (47%, n = 56) permanently discontinued dasatinib treatment, primarily due to intolerance (60%, n = 5). Pleural effusion was the most commonly occurring adverse event across all patients (29%, n = 34) and was the driving factor behind 30% of treatment discontinuations. Though nonhematologic adverse events persisted throughout long-term therapy for almost half the study population, dasatinib toxicity was tolerable overall.

“These findings support the importance of high-quality real-life data focusing not only on standard efficacy measurements, but also on long- term tolerance evaluation, with implications to [adverse events] awareness and optimal management,” concluded the authors.

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



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