Dasatinib or high-dose imatinib for chronic-phase chronic myeloid leukemia resistant to imatinib at a dose of 400 to 600 milligrams daily
Kantarjian H et al. - In a trial to assess the use of dasatinib and high-dose imatinib in chronic-phase chronic myeloid leukemia (CP-CML) resistant to imatinib, it was reported that after 2 yrs of follow-up, dasatinib demonstrated durable responses and improved response and progression-free survival (PFS) rates relative to high-dose imatinib. Methods- A phase 2, open-label study was initiated of 150 pts with imatinib-resistant CP-CML who were randomized (2:1) to receive either dasatinib 70 mg twice daily (n=101) or high-dose imatinib 800 mg (400 mg twice daily; n=49).
Results- At a minimum follow-up of 2 yrs, dasatinib demonstrated higher rates of complete hematologic response (93% vs 82%), major cytogenetic response (MCyR) (53% vs 33%), and complete cytogenetic response (44% vs 18%).
- At 18 mos, MCyR was maintained in 90% of pts on the dasatinib arm and in 74% of pts on the high-dose imatinib arm.
- Major molecular response rates were more frequent with dasatinib than with high-dose imatinib (29% vs 12%).
- Estimated PFS also favored dasatinib.
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