title: Combination of low-dose imatinib plus nilotinib for the treatment of chronic-phase chronic myeloid leukaemia after imatinib failure.
abstract: OBJECTIVE
  This is a feasibility study to evaluate whether simultaneous administration of low doses of imatinib and nilotinib in chronic-phase chronic myeloid leukaemia (CP-CML) patients has the potential for transcript elimination after failure to imatinib.
  
  
  METHODS
  Ten patients were enrolled; eight had cytogenetic relapse and two had confirmed loss of major molecular response (MMR). At baseline, BCR-ABL kinase domain mutation was detected in four patients.
  
  
  RESULTS
  After 6 months of therapy, major cytogenetic response, complete cytogenetic response, and MMR were achieved in seven, four, and four patients, respectively. Grade 4 thrombocytopenia developed in one patient, and grade 1 skin rash in four.
  
  
  CONCLUSIONS
  These results suggest that imatinib might have inhibitory effects on the clearance of nilotinib, increasing its efficacy. This dual therapy was well tolerated and resulted in improvement of cytogenetic and molecular responses in patients with CP-CML after failure to imatinib. ClinicalTrials.gov registration number: NCT01819389.
authors: a Hematology Service, Hospital Universitario 'Dr. José E. González' , Universidad Autónoma de Nuevo León , Monterrey , N.L. , México.
authors: David
authors: D
authors: Gómez-Almaguer
authors: a Hematology Service, Hospital Universitario 'Dr. José E. González' , Universidad Autónoma de Nuevo León , Monterrey , N.L. , México.
authors: Roxana
authors: R
authors: Saldaña-Vázquez
authors: a Hematology Service, Hospital Universitario 'Dr. José E. González' , Universidad Autónoma de Nuevo León , Monterrey , N.L. , México.
authors: Luz
authors: L
authors: Tarín-Arzaga
authors: a Hematology Service, Hospital Universitario 'Dr. José E. González' , Universidad Autónoma de Nuevo León , Monterrey , N.L. , México.
authors: Miguel Angel
authors: MA
authors: Herrera-Rojas
authors: a Hematology Service, Hospital Universitario 'Dr. José E. González' , Universidad Autónoma de Nuevo León , Monterrey , N.L. , México.
authors: Alberto
authors: A
authors: Vázquez-Mellado de Larracoechea
authors: a Hematology Service, Hospital Universitario 'Dr. José E. González' , Universidad Autónoma de Nuevo León , Monterrey , N.L. , México.
authors: Olga Graciela
authors: OG
authors: Cantú-Rodríguez
authors: a Hematology Service, Hospital Universitario 'Dr. José E. González' , Universidad Autónoma de Nuevo León , Monterrey , N.L. , México.
authors: Cesar Homero
authors: CH
authors: Gutiérrez-Aguirre
authors: a Hematology Service, Hospital Universitario 'Dr. José E. González' , Universidad Autónoma de Nuevo León , Monterrey , N.L. , México.
authors: José Carlos
authors: JC
authors: Jaime-Pérez
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate / Q000008:administration & dosage / Q000009:adverse effects; D015466:Leukemia, Myeloid, Chronic-Phase / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D000068877:Imatinib Mesylate; C498826:nilotinib
keywords: Chronic myeloid leukaemia; Imatinib; Imatinib failure; Nilotinib; Tyrosine kinase inhibitors combination