z-logo
open-access-imgOpen Access
How many chronic myeloid leukemia patients who started a frontline second‐generation tyrosine kinase inhibitor have to switch to a second‐line treatment? A retrospective analysis from the monitoring registries of the italian medicines agency (AIFA)
Author(s) -
Breccia Massimo,
Olimpieri Pier Paolo,
Olimpieri Odoardo,
Pane Fabrizio,
Iurlo Alessandra,
Foggi Paolo,
Cirilli Alessia,
Colatrella Antonietta,
Cuomo Marcello,
Gozzo Lucia,
Summa Valentina,
Corradini Paolo,
Russo Pierluigi
Publication year - 2020
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.3071
Subject(s) - nilotinib , dasatinib , medicine , discontinuation , ponatinib , tyrosine kinase inhibitor , myeloid leukemia , cohort , retrospective cohort study , imatinib , oncology , cancer
ABSTRACT The frequency of patients who switch to a second‐line therapy from a frontline second‐generation (2gen) tyrosine kinase inhibitor (TKI) such as dasatinib and nilotinib, is still substantially unknown. We retrospectively investigated a large series of chronic phase chronic myeloid leukemia (CP‐CML) patients initially treated with 2gen TKIs monitored through the Italian Medicines Agency (AIFA Agenzia Italiana del farmaco) registries. Overall, 2420 patients were analyzed over a period of 6 years. One hundred and fifty‐seven patients (16.3%) treated with dasatinib and 164 treated with nilotinib (11.3%) have switched to another drug, with an overall frequency of 13.2%. In the dasatinib cohort, 39.4% of patients changed treatment for failure and 36.3% for intolerance as compared to 45.7% and 27.4% respectively in the nilotinib cohort. Overall, the median time to switch due to resistance was 293 days, whereas it was 317 days in case of intolerance. Resistance was observed mainly in younger male patients with high‐risk features, while intolerance was not related to any baseline parameter. After resistance/intolerance to nilotinib, the majority of patients switched to dasatinib (53.8%) whereas in case of frontline dasatinib to ponatinib (43.2%). To the best of our knowledge these data provide the first report on the frequency of discontinuation of frontline 2gen TKIs and on the main causes and pattern of choice to a second‐line therapy in the real‐life setting.

The content you want is available to Zendy users.

Already have an account? Click here to sign in.
Having issues? You can contact us here