First-line chronic myeloid leukemia treatment with 2 nd generation tyrosine kinase inhibitors; a path to cure?

Abstract

Trials on therapy of newly diagnosed chronic myeloid leukemia in chronic phase with 2nd generation tyrosine kinase inhibitors (TKI) established their superiority over imatinib. Complete cytogenetic remissions, major and complete molecular response rates were higher in patients receiving dasatinib or nilotinib as initial therapy than in patients treated with imatinib, and were achieved much faster. Further investigations will elucidate if this will result in better eventfree survival than achieved with sequential therapy. Early and most potent inhibition of BCR- -ABL1 kinase might result in reduction of relapse and progression risk. Results of STIM trial suggests that in some patients complete molecular response achieved with imatinib may continue indefinitely after stopping therapy, and could be equal to cure. It is possible that initial CML therapy with 2^nd generation TKI could increase the number of those patients.
Hematologia 2011; 2, 3: 215–219