FOLLOW-UP OF LOWER DOSE DASATINIB 50MG DAILY AS FRONTLINE THERAPY IN NEWLY DIAGNOSED CHRONIC PHASE CHRONIC MYELOID LEUKEMIA (CML-CP)
Author(s): ,
Kiran Naqvi
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Elias Jabbour
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Jeffrey Skinner
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Kristin Anderson
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Musa Yilmaz
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Alessandra Ferrajoli
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Prithviraj Bose
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Philip Thompson
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Yesid Alvarado
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Nitin Jain
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Koichi Takahashi
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Jan Burger
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Zeev Estrov
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Gautam Borthakur
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Naveen Pemmaraju
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Sara Dellasala
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Shilpa Paul
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
,
Jorge Cortes
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
Hagop Kantarjian
Affiliations:
Leukemia Department,MD ANDERSON CANCER CENTER,Houston,United States
EHA Library. Naqvi K. Jun 15, 2019; 266797; PS1180
Dr. Kiran Naqvi
Dr. Kiran Naqvi
Contributions
Abstract

Abstract: PS1180

Type: Poster Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 17:30 - 19:00

Location: Poster area

Background
Background: Dasatinib, a potent BCR-ABL tyrosine kinase inhibitor (TKI), is approved for the treatment of chronic phase CML (CML-CP) in the frontline and salvage settings. Notable side effects include pleural effusions and myelosuppression. We previously reported dasatinib 50mg daily to be active and better tolerated than the approved 100mg daily dose (CANCER. 2018 Jul 1;124(13):2740-2747).

Aims
An update on the efficacy and toxicity profile of lower dose dasatinib 50 mg orally daily in patients with early CML-CP.

Methods
All patients presenting to our institution in early CML-CP were eligible to participate. Prior TKI therapy for up to 1 month was allowed. Responses were assessed according to the European LeukemiaNet guidelines (Baccarani et al. Blood 2013 122.872:884). 

Results
From March 2016 to March 2018, 81 patients have been enrolled. Median age is 47 years (20-84). Patients categorized by Sokal risk are: low 53; intermediate 22 and high 6.  Median follow-up is 18 months (9-31). Cumulative response rates (n=81) over time are shown in the gragh below.

At 3 months, 96% patients achieved early molecular response (BCR-ABL PCR ≤10%). Median time to CCyR was 4.6 months, MMR 6.0 months, MR4.0 11.4 months and MR4.5 12.2 months. Eighteen patients had treatment interruption: pleural effusion 4 (possibly related 3, unrelated 1 due to pneumonia); gastrointestinal bleed 2; thrombocytopenia 3; transaminitis 2; renal dysfunction 1; asthma exacerbation 1; pneumonitis 1; lower extremity edema 1; myalgias 1, and pregnancy 2. Four patients had dose reductions: pleural effusion 3; myalgias 1. Four patients had dasatinib dose increased to 100mg: lack of CCyR at 6 months, 3; lack of MMR at 12 months, 1. Four patients are off study: no response 2, pneumonitis 1, and insurance 1. None of the patients have transformed or died.

Conclusion
These updated results continue to support dasatinib 50mg daily as an effective and safe dose for early CML-CP.

Session topic: 8. Chronic myeloid leukemia - Clinical

Keyword(s): Chronic myeloid leukemia, Tyrosine kinase inhibitor

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