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Retrospective analysis of nilotinib and dasatinib efficacy in second line treatment of chronic myeloid leukemia in Polish hematological centers
Affiliations- Pracownia Immunologii Klinicznej, Transplantacyjnej i Genetyki, Wojewódzki Szpital Specjalistyczny im. M. Kopernika w Łodzi, Łódź, Polska
- Klinika Hematologii, Instytut Hematologii i Transfuzjologii, Warszawa, Polska
- Klinika Hematologii Uniwersytetu Jagiellońskiego, Kraków, Polska
- Klinika Hematologii i Transplantologii, Gdański Uniwersytet Medyczny, Gdańsk, Polska
- Regionalne Centrum Onkologii, Gdańsk, Polska
- Klinika Hematologii, Miejski Szpital Specjalistyczny im. M. Kopernika w Toruniu, Toruń, Polska
- Klinika Hematologii, Kliniczny Szpital Wojewódzki nr 1 im. F. Chopina, Rzeszów, Polska
- Klinika Gastroenterologii, Hepatologii i Onkologii Klinicznej, Centrum Medycznego Kształcenia Podyplomowego, Warszawa, Polska
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Abstract
Until now, there has been no randomized study directly comparing the activity of second-generation BCR-ABL tyrosine kinase inhibitors (TKI-2G) nilotinib and dasatinib in chronic myeloid leukemia (CML). The aim of our study was to retrospectively analyze efficacy of nilotinib and dasatinib in the real life setting of CML with resistance or intolerance of imatinib. Of 108 included patients treated in polish hematology centers, 75 received dasatinib and 33 patients received nilotinib. Rates of complete cytogenetic response (CCyR) did not differ between the two groups of patients. After six months of therapy, CCyR was achieved in 34.7% of patients treated with dasatinib and 38.7% treated with nilotinib (p=0.86), while after 12 months, the CCyR rates were 60.0% and 77.0% in dasatinib and nilotinib groups, respectively (p=0.11). Moreover, we have not observed any significant difference in the probability of progression-free survival (p=0.89) or overall survival (p=0.99) between patients treated with these two TKI-2G. In conclusion, the results of our analysis indicate that nilotinib and dasatinib have comparable and satisfactory efficacy in the treatment of CML patients refractory or intolerant to imatinib. Our findings support current strategy of choice of IKT-2G according to drug toxicity profile and risk of specific adverse events in an individual patient.
Abstract
Until now, there has been no randomized study directly comparing the activity of second-generation BCR-ABL tyrosine kinase inhibitors (TKI-2G) nilotinib and dasatinib in chronic myeloid leukemia (CML). The aim of our study was to retrospectively analyze efficacy of nilotinib and dasatinib in the real life setting of CML with resistance or intolerance of imatinib. Of 108 included patients treated in polish hematology centers, 75 received dasatinib and 33 patients received nilotinib. Rates of complete cytogenetic response (CCyR) did not differ between the two groups of patients. After six months of therapy, CCyR was achieved in 34.7% of patients treated with dasatinib and 38.7% treated with nilotinib (p=0.86), while after 12 months, the CCyR rates were 60.0% and 77.0% in dasatinib and nilotinib groups, respectively (p=0.11). Moreover, we have not observed any significant difference in the probability of progression-free survival (p=0.89) or overall survival (p=0.99) between patients treated with these two TKI-2G. In conclusion, the results of our analysis indicate that nilotinib and dasatinib have comparable and satisfactory efficacy in the treatment of CML patients refractory or intolerant to imatinib. Our findings support current strategy of choice of IKT-2G according to drug toxicity profile and risk of specific adverse events in an individual patient.
Keywords
Chronic myeloid leukemia; Imatinib resistance; Nilotinib; Dasatinib
About this articleTitle
Retrospective analysis of nilotinib and dasatinib efficacy in second line treatment of chronic myeloid leukemia in Polish hematological centers
Journal
Issue
Pages
219-225
Published online
2016-07-01
Page views
120
Article views/downloads
122
DOI
10.1016/j.achaem.2016.08.002
Bibliographic record
Acta Haematol Pol 2016;47(3):219-225.
Keywords
Chronic myeloid leukemia
Imatinib resistance
Nilotinib
Dasatinib
Authors
Anna Stępień
Krzysztof Jamroziak
Tomasz Sacha
Dorota Link-Lenczowska
Izabela Florek
Witold Prejzner
Zofia Specht-Szwoch
Małgorzata Całbecka
Marcin Rymko
Marek Dudziński
Paulina Wieszczy
Krzysztof Warzocha
Janina Góra-Tybor