Ibrahim, A.R., Clark, R.E., Holyoake, T.L., Byrne, J., Shepherd, P., Apperley, J.F., Milojkovic, D., Szydlo, R., Goldman, J. and Marin, D. (2011) Second-generation tyrosine kinase inhibitors improve the survival of patients with chronic myeloid leukemia in whom imatinib therapy has failed. Haematologica, 96(12), pp. 1779-1782. (doi: 10.3324/haematol.2011.049759)
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Publisher's URL: http://dx.doi.org/10.3324/haematol.2011.049759
Abstract
<p><b>Background:</b> It has not been clearly established whether second-generation tyrosine kinase inhibitors actually improve the survival of patients with chronic myeloid leukemia in chronic phase who are given nilotinib or dasatinib therapy after treatment failure with imatinib.</p> <p><b>Design and Methods:</b> To address this issue we compared the survival of 104 patients in whom first-line therapy with imatinib failed and who were then treated with second-generation tyrosine kinase inhibitors with the outcome of 246 patients in whom interferon-a therapy failed and who did not receive tyrosine kinase inhibitor therapy.</p> <p><b>Results:</b> Patients treated with second-generation tyrosine kinase inhibitors had longer overall survival than the interferon controls (adjusted relative risk = 0.28, P = 0.0001). However this survival advantage was limited to the 64.4% of patients in whom imatinib failed but who achieved complete cytogenetic response with the subsequent tyrosine kinase inhibitor (adjusted relative risk = 0.05, P = 0.003), whereas the 35.6% of patients who failed to achieve complete cytogenetic response on the second or third inhibitor had similar overall survival to that of the controls (adjusted relative risk = 0.76, P = 0.65).</p> <p><b>Conclusions:</b> Patients in whom imatinib treatment fails who receive sequential therapy with second-generation tyrosine kinase inhibitors have an enormous advantage in survival over controls (palliative therapy); this advantage is, however, limited to the majority of the patients who achieve a complete cytogenetic response.</p>
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Holyoake, Professor Tessa |
Authors: | Ibrahim, A.R., Clark, R.E., Holyoake, T.L., Byrne, J., Shepherd, P., Apperley, J.F., Milojkovic, D., Szydlo, R., Goldman, J., and Marin, D. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cancer Sciences |
Journal Name: | Haematologica |
ISSN: | 0390-6078 |
ISSN (Online): | 1592-8721 |
Published Online: | 22 August 2011 |
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