First-line treatment of chronic myeloid leukemia with nilotinib: critical evaluation
Pier Paolo Piccaluga,* Stefania Paolini,* Clara Bertuzzi, Antonio De Leo, Gianantonio RostiHematopathology and Hematology Sections, Department of Hematology and Oncological Sciences, "L and A Seràgnoli", S Orsola-Malpighi Hospital, University of Bologna, Bolo...
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2012-11-01
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doaj-b9fde7ac91444f6ea3dfa89a608e2ddc2020-11-24T22:42:33ZengDove Medical PressJournal of Blood Medicine1179-27362012-11-012012default151156First-line treatment of chronic myeloid leukemia with nilotinib: critical evaluationPiccaluga PPPaolini SBertuzzi CDe Leo ARosti GPier Paolo Piccaluga,* Stefania Paolini,* Clara Bertuzzi, Antonio De Leo, Gianantonio RostiHematopathology and Hematology Sections, Department of Hematology and Oncological Sciences, "L and A Seràgnoli", S Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy*These authors contributed equally to this workAbstract: The therapeutic landscape of chronic myeloid leukemia (CML) has changed dramatically in the last decade. In particular, the availability of imatinib mesylate, a tyrosine kinase inhibitor targeting BCR-ABL, has led to profound and durable remissions in the majority of patients. However, a couple of issues have emerged and partially obscured this scenario. First, it has become clear that a significant proportion of patients either present with primary resistance to imatinib or develop secondary resistance sooner or later during treatment. Second, although the drug is generally well tolerated, a percentage of patients eventually cease treatment because of toxicity. Bearing this in mind, second-generation tyrosine kinase inhibitors have been introduced, including nilotinib. Phase I and II studies indicate remarkable activity for this compound in CML cases resistant to imatinib, including some of those carrying BCR-ABL1 mutants. More recently, two Phase II studies and a III randomized Phase clinical trial demonstrated the superiority of nilotinib compared with imatinib in terms of complete cytogenetic and major molecular responses, which are two relevant surrogate measures of long-term survival in CML. In this paper, we review the most relevant data on nilotinib as first-line treatment for CML, and discuss the rationale for its routine use, as well as some possible future perspectives for CML patients.Keywords: chronic myeloid leukemia, nilotinib, targeted therapy, BCR-ABL1http://www.dovepress.com/first-line-treatment-of-chronic-myeloid-leukemia-with-nilotinib-critic-a11633 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Piccaluga PP Paolini S Bertuzzi C De Leo A Rosti G |
spellingShingle |
Piccaluga PP Paolini S Bertuzzi C De Leo A Rosti G First-line treatment of chronic myeloid leukemia with nilotinib: critical evaluation Journal of Blood Medicine |
author_facet |
Piccaluga PP Paolini S Bertuzzi C De Leo A Rosti G |
author_sort |
Piccaluga PP |
title |
First-line treatment of chronic myeloid leukemia with nilotinib: critical evaluation |
title_short |
First-line treatment of chronic myeloid leukemia with nilotinib: critical evaluation |
title_full |
First-line treatment of chronic myeloid leukemia with nilotinib: critical evaluation |
title_fullStr |
First-line treatment of chronic myeloid leukemia with nilotinib: critical evaluation |
title_full_unstemmed |
First-line treatment of chronic myeloid leukemia with nilotinib: critical evaluation |
title_sort |
first-line treatment of chronic myeloid leukemia with nilotinib: critical evaluation |
publisher |
Dove Medical Press |
series |
Journal of Blood Medicine |
issn |
1179-2736 |
publishDate |
2012-11-01 |
description |
Pier Paolo Piccaluga,* Stefania Paolini,* Clara Bertuzzi, Antonio De Leo, Gianantonio RostiHematopathology and Hematology Sections, Department of Hematology and Oncological Sciences, "L and A Seràgnoli", S Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy*These authors contributed equally to this workAbstract: The therapeutic landscape of chronic myeloid leukemia (CML) has changed dramatically in the last decade. In particular, the availability of imatinib mesylate, a tyrosine kinase inhibitor targeting BCR-ABL, has led to profound and durable remissions in the majority of patients. However, a couple of issues have emerged and partially obscured this scenario. First, it has become clear that a significant proportion of patients either present with primary resistance to imatinib or develop secondary resistance sooner or later during treatment. Second, although the drug is generally well tolerated, a percentage of patients eventually cease treatment because of toxicity. Bearing this in mind, second-generation tyrosine kinase inhibitors have been introduced, including nilotinib. Phase I and II studies indicate remarkable activity for this compound in CML cases resistant to imatinib, including some of those carrying BCR-ABL1 mutants. More recently, two Phase II studies and a III randomized Phase clinical trial demonstrated the superiority of nilotinib compared with imatinib in terms of complete cytogenetic and major molecular responses, which are two relevant surrogate measures of long-term survival in CML. In this paper, we review the most relevant data on nilotinib as first-line treatment for CML, and discuss the rationale for its routine use, as well as some possible future perspectives for CML patients.Keywords: chronic myeloid leukemia, nilotinib, targeted therapy, BCR-ABL1 |
url |
http://www.dovepress.com/first-line-treatment-of-chronic-myeloid-leukemia-with-nilotinib-critic-a11633 |
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