title: Moving on up: Second-Line Agents as Initial Treatment for Newly-Diagnosed Patients with Chronic Phase CML.
abstract: The treatment of chronic myelogenous leukemia (CML) was revolutionized by the development of imatinib mesylate, a small molecule inhibitor of several protein tyrosine kinases, including the ABL1 protein tyrosine kinase. The current second generation of FDA-approved ABL tyrosine kinase inhibitors, dasatinib and nilotinib, are more potent inhibitors of BCR-ABL1 kinase in vitro. Originally approved for the treatment of patients who were refractory to or intolerant of imatinib, dasatinib and nilotinib are now also FDA approved in the first-line setting. The choice of tyrosine kinase inhibitor (ie, standard or high dose imatinib, dasatinib, nilotinib) to use for initial therapy in chronic-phase CML (CML-CP) will not always be obvious. Therapy selection will depend on both clinical and molecular factors, which we will discuss in this review.
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, and Chao Family Comprehensive Cancer Center, University of California, Irvine, CA, USA.
authors.forename: Marie P
authors.initials: MP
authors.lastname: Shieh
authors.forename: Masato
authors.initials: M
authors.lastname: Mitsuhashi
authors.forename: Michael
authors.initials: M
authors.lastname: Lilly