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Dasatinib induces fast and deep responses in newly diagnosed chronic myeloid leukaemia patients in chronic phase: clinical results from a randomised phase‐2 study (NordCML006)
Authors:Henrik Hjorth‐Hansen,Leif Stenke,Stina S  derlund,Arta Dreimane,Hans Ehrencrona,Tobias Gedde‐Dahl,Bj  rn Tore Gjertsen,Martin H  glund,Perttu Koskenvesa,Kourosh Lotfi,Waleed Majeed,Berit Markev  rn,Lotta Ohm,Ulla Olsson‐Str  mberg,Kari Remes,Merja Suominen,Bengt Simonsson,Kimmo Porkka,Satu Mustjoki,Johan Richter
Affiliation:1. Department of Hematology, St Olavs Hospital, Trondheim, Norway;2. Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway;3. Department of Hematology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden;4. Department of Hematology, Uppsala University Hospital, Uppsala, Sweden;5. Department of Medical and Health Sciences, Link?ping University, Link?ping, Sweden;6. Department of Hematology, County Council of ?sterg?tland, Link?ping, Sweden;7. Department of Clinical Genetics, Sk?ne University Hospital, Lund, Sweden;8. Department of Hematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway;9. Hematology Section, Department of Internal Medicine, Haukeland University Hospital, Bergen, Norway;10. Department of Clinical Science, University of Bergen, Bergen, Norway;11. Hematology Research Unit Helsinki, University of Helsinki, Helsinki, Finland;12. Department of Hematology, Helsinki University Central Hospital Cancer Center, Helsinki, Finland;13. Department of Hematooncology, Stavanger University Hospital, Stavanger, Norway;14. Department of Hematology, Ume? University Hospital, Ume?, Sweden;15. Turku University Central Hospital, Turku, Finland;16. Kanta‐H?me Central Hospital, H?meenlinna, Finland
Abstract:We randomised 46 newly diagnosed patients with chronic myeloid leukaemia (median age 56) to receive dasatinib 100 mg QD or imatinib 400 mg QD and report outcome as an intention‐to‐treat analysis with 36 months follow‐up. Early cytogenetic and molecular responses were superior in the dasatinib group, with a tendency that imatinib patients caught up with time. For instance, MR3.0 was reached at 3 months in 36% vs. 8% (= 0.02), at 12 months in 81% vs. 46% (= 0.02) and at 18 months in 73% vs. 65% (n.s.) of the patients in the two groups. In contrast, MR4.5 was consistently superior in the dasatinib group at all time points from 6 months onwards, reaching 61% vs. 21% (< 0.05) at 36 months. Sixty‐four vs. 71% of the patients in the dasatinib and imatinib arms, respectively, remained on assigned drug. Dasatinib dose was frequently reduced, but with maintained excellent effect. One imatinib patient progressed to blastic phase, but no CML‐related deaths occurred. In conclusion, our data compare favourably with those of the dasatinib registration study, DASISION. The fast and deep molecular responses induced by dasatinib compared with imatinib may be exploited to increase the proportion of patients who can achieve a treatment‐free remission after treatment discontinuation.
Keywords:dasatinib  imatinib  randomized controlled trial  deep response  toxicity
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