Nilotinib and dasatinib associated with superior 12-month outcomes compared to imatinib

-- Rick Ansorge

Monday, June 7, 2010 (Last Updated: 06/08/2010)

MONDAY, June 7 (HealthDay News) -- In patients with newly diagnosed chronic myeloid leukemia, treatment with either nilotinib or dasatinib is associated with superior 12-month outcomes compared to treatment with imatinib, according to two studies published online June 5 in the New England Journal of Medicine to coincide with presentations at the 46th Annual Meeting of the American Society of Clinical Oncology, held from June 4 to 8 in Chicago.

In one study, Giuseppe Saglio, M.D., of the University of Turin in Italy, and colleagues randomly assigned 846 patients with newly diagnosed chronic-phase Philadelphia chromosome-positive chronic myeloid leukemia to receive either twice-daily nilotinib (at doses of 300 mg or 400 mg) or a once-daily 400-mg dose of imatinib. After 12 months, they found that both doses of nilotinib were associated with significantly higher rates of major molecular response (44 and 43 percent, respectively) than imatinib (22 percent). The rates of complete cytogenetic response were also higher with nilotinib.

In a related study, Hagop Kantarjian, M.D., of the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues randomly assigned 519 patients with newly diagnosed chronic-phase chronic myeloid leukemia to receive daily doses of either 100-mg dasatinib or 400-mg imatinib. After a follow-up of at least 12 months, they found that dasatinib was associated with a significantly higher rate of confirmed complete cytogenetic response than imatinib (77 versus 66 percent). The rate of major molecular response was also higher with dasatinib.

"These two studies cap a remarkable decade of progress in chronic myeloid leukemia therapy and, for some, may raise the question of whether we have reached the limit of what we can hope to achieve," states the author of an accompanying editorial. "We know that imatinib induces a long-lasting remission but not a cure. Presumably, dasatinib and nilotinib will perform similarly, but with deeper, longer-lasting remissions."

The first study was supported by Novartis Pharmaceuticals, which manufactures nilotinib and imatinib and employs two study authors. The second study was supported by Bristol-Myers Squibb, which manufactures dasatinib and employs several study authors.

Abstract - Saglio
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Abstract - Kantarjian
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Specialties Hematology & Oncology

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