Dasatinib in the treatment of chronic myeloid leukemia in accelerated phase after imatinib failure : the START a trial

Apperley, Jane F. and Cortes, Jorge E. and Kim, Dong-Wook and Roy, Lydia and Roboz, Gail J. and Rosti, Gianantonio and Bullorsky, Eduardo O. and Abruzzese, Elisabetta and Hochhaus, Andreas and Heim, Dominik and de Souza, Carmino A. and Larson, Richard A. and Lipton, Jeffrey H. and Khoury, H. Jean and Kim, Hyeoung-Joon and Sillaber, Christian and Hughes, Timothy P. and Erben, Philipp and Van Tornout, Jan and Stone, Richard M.. (2009) Dasatinib in the treatment of chronic myeloid leukemia in accelerated phase after imatinib failure : the START a trial. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Vol. 27. pp. 3472-3479.

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Official URL: http://edoc.unibas.ch/dok/A6002933

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PURPOSE Patients with chronic myelogenous leukemia in accelerated phase (CML-AP) that is resistant or intolerant to imatinib have limited therapeutic options. Dasatinib, a potent inhibitor of BCR-ABL and SRC-family kinases, has efficacy in patients with CML-AP who have experienced treatment failure with imatinib. We now report follow-up data from the full patient cohort of 174 patients enrolled onto a phase II trial to provide a more complete assessment of the efficacy and safety of dasatinib in this population. PATIENTS AND METHODS Patients with imatinib-resistant (n = 161) or -intolerant (n = 13) CML-AP received dasatinib 70 mg orally twice daily. Results At a median follow-up of 14.1 months (treatment duration, 0.1 to 21.7 months), major and complete hematologic responses were attained by 64% and 45% of patients, respectively, and major and complete cytogenetic responses were achieved in 39% and 32% of patients, respectively. Responses were achieved irrespective of imatinib status (resistant or intolerant), prior stem-cell transplantation, or the presence of prior BCR-ABL mutation. The 12-month progression-free survival and overall survival rates were 66% and 82%, respectively. Dasatinib was generally well tolerated; the most frequent nonhematologic severe treatment-related adverse event was diarrhea (52%; grade 3 to 4, 8%). Cytopenias were common, including grade 3 to 4 neutropenia (76%) and thrombocytopenia (82%). Pleural effusion occurred in 27% of patients (grade 3 to 4, 5%). CONCLUSION Dasatinib is effective in patients with CML-AP after imatinib treatment failure.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Hämatologie > Hämatologie (Passweg)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Hämatologie > Hämatologie (Passweg)
UniBasel Contributors:Heim, Dominik A.
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:American Society of Clinical Oncology
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:01 Mar 2013 11:13
Deposited On:01 Mar 2013 11:08

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