title: Comparative efficacy of tyrosine kinase inhibitor treatments in the third-line setting, for chronic-phase chronic myelogenous leukemia after failure of second-generation tyrosine kinase inhibitors.
abstract: We compared the efficacy of ponatinib and second-generation tyrosine kinase inhibitors (2G-TKIs: bosutinib, dasatinib, and nilotinib) in chronic phase CML resistant/intolerant to ≥1 prior 2G-TKI. Estimated probabilities of CCyR with 2G-TKI ranged from 22% to 26%, compared with 60% (95% CrI 52-68%) with ponatinib. The estimated probability of ponatinib providing higher response rate than all other included treatments was 99% (CCyR) and 97% (MCyR). Use of further 2G-TKI may provide limited benefit in CP-CML patients resistant/intolerant to prior 2G-TKI treatment. Compared with 2G-TKIs, ponatinib is estimated to provide substantially higher probability of achieving CCyR and MCyR; safety was not compared.
authors.affiliation: Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
authors.forename: J H
authors.initials: JH
authors.lastname: Lipton
authors.affiliation: ICON Health Economics, Oxford, UK.
authors.forename: P
authors.initials: P
authors.lastname: Bryden
authors.affiliation: ICON Health Economics, Morristown, NJ, USA. Electronic address: Manpreet.sidhu@iconplc.com.
authors.forename: M K
authors.initials: MK
authors.lastname: Sidhu
authors.affiliation: ARIAD Pharmaceuticals, Inc., Cambridge, MA, USA.
authors.forename: H
authors.initials: H
authors.lastname: Huang
authors.affiliation: ARIAD Pharmaceuticals, Inc., Cambridge, MA, USA.
authors.forename: L J
authors.initials: LJ
authors.lastname: McGarry
authors.affiliation: ARIAD Pharmaceuticals, Inc., Cambridge, MA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Lustgarten
authors.affiliation: ICON Health Economics, Oxford, UK.
authors.forename: S
authors.initials: S
authors.lastname: Mealing
authors.affiliation: ICON Health Economics, Oxford, UK.
authors.forename: B
authors.initials: B
authors.lastname: Woods
authors.affiliation: ICON Health Economics, Oxford, UK.
authors.forename: J
authors.initials: J
authors.lastname: Whelan
authors.affiliation: ICON Health Economics, Oxford, UK.
authors.forename: N
authors.initials: N
authors.lastname: Hawkins
mesh_terms: D018572:Disease-Free Survival; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000401:mortality; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D015996:Survival Rate
chemical_list: D047428:Protein Kinase Inhibitors
keywords: CML; Ponatinib; Response; Second-generation tyrosine kinase inhibitor; Systematic review