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Bosutinib in the real‐life treatment of chronic myeloid leukemia patients aged >65 years resistant/intolerant to previous tyrosine‐kinase inhibitors
Author(s) -
Latagliata Roberto,
Attolico Immacolata,
Trawinska Malgorzata Monika,
Capodanno Isabella,
Annunziata Mario,
Elena Chiara,
Luciano Luigiana,
Crugnola Monica,
Bergamaschi Micaela,
Bonifacio Massimiliano,
Baratè Claudia,
Mauro Endri,
Binotto Gianni,
Sgherza Nicola,
Aguzzi Chiara,
Monteleone Barbara,
Sorà Federica,
Caocci Giovanni,
Luzi Debora,
Mariggiò Elena,
Scaffidi Luigi,
Cattaneo Daniele,
Gozzini Antonella,
Di Veroli Ambra,
Abruzzese Elisabetta,
Galimberti Sara,
Iurlo Alessandra,
Specchia Giorgina,
Breccia Massimo
Publication year - 2021
Publication title -
hematological oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 44
eISSN - 1099-1069
pISSN - 0278-0232
DOI - 10.1002/hon.2851
Subject(s) - bosutinib , medicine , discontinuation , gastroenterology , cohort , toxicity , myeloid leukemia , tyrosine kinase inhibitor , surgery , oncology , nilotinib , imatinib , cancer
To evaluate the role of bosutinib in elderly patients aged >65 years with chronic myeloid leukemia (CML), a real‐life cohort of 101 chronic‐phase CML patients followed up in 23 Italian centers and treated with bosutinib in second or a subsequent line was retrospectively evaluated. Starting dose of bosutinib was 500 mg/day in 25 patients (24.8%), 400 mg/day in 7 patients (6.9%), 300 mg/day in 33 patients (32.7%), 200 mg/day in 34 patients (33.6%), and 100 mg/day in 2 patients (2.0%). Grade 3/4 hematological toxicity occurred in 7/101 patients (6.9%) and grade 3/4 extra‐hematological toxicity in 19/101 patients (18.8%). Permanent bosutinib discontinuation due to toxicity was needed in 12 patients (11.9%). Among the 96 patients evaluable for response, 74 (77.0%) achieved a complete cytogenetic response (CCyR), while 64 of these 74 patients in CCyR (66.6% of all 96 evaluable patients) also achieved a molecular response (MR) (major MR [MR 3.0] in 21 [21.8%], deep MR [MR 4.0/4.5] in 43 [44.8%]). The 3‐year event‐free survival and overall survival of the whole patients' cohort from bosutinib start were 60.9% (CI 95% 49.3–72.5) and 86.4% (CI 95% 77.2–95.6), respectively. Our real‐life data show that bosutinib is effective, with a favorable safety profile, also in elderly patients with important comorbidities and resistance and/or intolerance to previous tyrosine‐kinase inhibitor treatments. As a consequence, it could play a significant role in current clinical practice for frail patients.