Improving frontline treatment for chronic myeloid leukemia: emerging evidence for use of nilotinib and dasatinib.

摘要: The approval of imatinib in 2001 changed the landscape chronic myeloid leukemia (CML) management, becoming standard care and improving survival rates patients. With prevalent use worldwide, it was observed that up to one-third patients are resistant or intolerant therapy, fueling search for safer more effective agents. newer potent tyrosine kinase inhibitors nilotinib dasatinib were first indicated treatment imatinib-resistant/-intolerant patients, whom these agents both safe efficacious. More recent clinical studies have examined frontline setting newly diagnosed Data reported from phase III ENESTnd (Evaluating Nilotinib Efficacy Safety Clinical Trials-Newly Diagnosed Patients) study DASISION (Dasatinib versus Imatinib Patients with Newly Chronic-phase CML) trial support as potential new standards CML phase. Furthermore, received regulatory These demonstrated significantly superior efficacy compared imatinib, measured by complete cytogenetic response major molecular rates. In addition, progression advanced disease lower nilotinib, a trend toward dasatinib. Although generally well tolerated setting, they different safety profiles may affect their selection treatment. Understanding effi - cacy, profiles, patterns resistance various BCR-ABL1 mutations agents, implementing manage- ment strategies treat adverse events, will help physicians provide best therapy options CML.