Outcome of 82 chronic myeloid leukemia patients treated with nilotinib or dasatinib after failure of two prior tyrosine kinase inhibitors.
There have been few reports of a response to dasatinib or nilotinib after failure of two prior sequential tyrosine kinase inhibitors. We report the outcome of 82 chronic phase patients who received nilotinib or dasatinib as third-line alternative tyrosine kinase inhibitor therapy. Thirty-four patients failed to respond to nilotinib and were started on dasatinib as third-line tyrosine kinase inhibitor therapy while 48 patients were switched to nilotinib after dasatinib failure. Overall, we obtained a cytogenetic response in 32 of 82 patients and major molecular response in 13 patients; disease progression occurred in 12 patients. At last follow up, 70 patients (85.4%) were alive with a median overall survival of 46 months. Our results show that third-line tyrosine kinase inhibitor therapy in chronic myeloid leukemia patients after failure of two prior sequential tyrosine kinase inhibitors may induce a response that, in some instances, could prolong overall survival and affect event-free survival.
Ematologia con Trapianto, Università degli Studi di Bari Aldo Moro, Bari, Italy.
Antonella
A
Russo Rossi
Massimo
M
Breccia
Elisabetta
E
Abruzzese
Fausto
F
Castagnetti
Luigiana
L
Luciano
Antonella
A
Gozzini
Mario
M
Annunziata
Bruno
B
Martino
Fabio
F
Stagno
Francesco
F
Cavazzini
Mario
M
Tiribelli
Giuseppe
G
Visani
Patrizia
P
Pregno
Pellegrino
P
Musto
Carmen
C
Fava
Nicola
N
Sgherza
Francesco
F
Albano
Gianantonio
G
Rosti
Giuliana
G
Alimena
Giorgina
G
Specchia
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000069439:Dasatinib; D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011743:Pyrimidines / Q000009:adverse effects / Q000627:therapeutic use*; D013844:Thiazoles / Q000009:adverse effects / Q000627:therapeutic use*; D017211:Treatment Failure; D016896:Treatment Outcome
D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D013844:Thiazoles; C498826:nilotinib; D000069439:Dasatinib