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Clinical Medicine Insights: Oncology

Moving on up: Second-Line Agents as Initial Treatment for Newly-Diagnosed Patients with Chronic Phase CML

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Clinical Medicine Insights: Oncology 2011:5 185-199

Review

Published on 23 Jun 2011

DOI: 10.4137/CMO.S6416


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The Editor-in-Chief has endorsed this article

The review is concise and covers a broad aspect of initial treatment of newly-diagnosed patients with chronic phase CML with tyrosine kinase inhibitors.

Abstract

The treatment of chronic myelogenous leukemia (CML) was revolutionized by the development of imatinib mesylate, a small molecule inhibitor of several protein tyrosine kinases, including the ABL1 protein tyrosine kinase. The current second generation of FDA-approved ABL tyrosine kinase inhibitors, dasatinib and nilotinib, are more potent inhibitors of BCR-ABL1 kinase in vitro. Originally approved for the treatment of patients who were refractory to or intolerant of imatinib, dasatinib and nilotinib are now also FDA approved in the first-line setting. The choice of tyrosine kinase inhibitor (ie, standard or high dose imatinib, dasatinib, nilotinib) to use for initial therapy in chronic-phase CML (CML-CP) will not always be obvious. Therapy selection will depend on both clinical and molecular factors, which we will discuss in this review.



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