Outcome of 82 chronic myeloid leukemia patients treated with nilotinib or dasatinib after failure of two prior tyrosine kinase inhibitors

• Published in: Haematologica (Roma) Vol. 98; no. 3; pp. 399 - 403
• Main Authors: Rossi, A. R., Breccia, M., Abruzzese, E., Castagnetti, F., Luciano, L., Gozzini, A., Annunziata, M., Martino, B., Stagno, F., Cavazzini, F., Tiribelli, M., Visani, G., Pregno, P., Musto, P., Fava, C., Sgherza, N., Albano, F., Rosti, G., Alimena, G., Specchia, G.
• Format: Journal Article
• Language: English
• Published: Italy Ferrata Storti Foundation 01.03.2013
• Subjects: Adult; Aged; Aged, 80 and over; Dasatinib; Female; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - mortality; Male; Middle Aged; Protein Kinase Inhibitors - adverse effects; Protein Kinase Inhibitors - therapeutic use; Pyrimidines - adverse effects; Pyrimidines - therapeutic use; Thiazoles - adverse effects; Thiazoles - therapeutic use; Treatment Failure; Treatment Outcome
• ISSN: 0390-6078; 1592-8721; 1592-8721
• DOI: 10.3324/haematol.2012.064337

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.