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).

Massimo Breccia, Pier Paolo Olimpieri, Odoardo Olimpieri, Fabrizio Pane, Alessandra Iurlo, Paolo Foggi, Alessia Cirilli, Antonietta Colatrella, Marcello Cuomo, Lucia Gozzo, Valentina Summa, Paolo Corradini, Pierluigi Russo

Research output: Contribution to journalArticlepeer-review

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 39.46.35.77.4 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.
Original languageEnglish
Pages (from-to)4160-4165
Number of pages6
JournalCancer Med.
Volume9
Issue number12
DOIs
Publication statusPublished - Jun 1 2020

Keywords

  • *chronic myeloid leukemia
  • *failure
  • *intolerance
  • *second-generation TKIs

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