Tyrosine Kinase Inhibitor Sequencing in Patients with Chronic Myeloid Leukemia

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Tiribelli M., Eşkazan A. E.

ONCOLOGY AND THERAPY, cilt.7, ss.95-100, 2019 (ESCI İndekslerine Giren Dergi) identifier

  • Yayın Türü: Makale / Editöre Mektup
  • Cilt numarası: 7
  • Basım Tarihi: 2019
  • Doi Numarası: 10.1007/s40487-019-00098-w
  • Sayfa Sayıları: ss.95-100


The management of chronic myeloid leukemia (CML) has been revolutionized by the discovery of tyrosine kinase inhibitors (TKIs) against BCR-ABL1 oncogenic fusion protein. Imatinib, the first BCR-ABL1 TKI, was introduced into clinical practice in the early 2000s. In the following years, the so-called second-generation TKIs (2GTKIs)-dasatinib, nilotinib, and bosutinib were approved, initially for patients resistant to imatinib, and subsequently for front-line treatment. With multiple TKIs available, selection of first-line therapy is challenging. CML risk, patient characteristics and potential toxicities of different TKIs play a fundamental role, in particular when deciding between imatinib and 2GTKIs as frontline treatment. So, when deciding front-line therapy for a patient with CML in the chronic phase (CML-CP), clinicians must consider both the long-term outcomes, such as overall survival and progression-free survival, as well as safety, tolerance and possible treatment discontinuation. This paper offers a practical algorithmic approach for the sequential use of commercially available TKIs in patients with CML-CP along with the data available in the literature.