Although Gleevec® (imatinib) was lauded as a “smart bomb” for chronic myeloid leukemia 10 years ago, today second-line drugs — Tasigna® (nilotinib) and Sprycel® (dasatinib) — are providing quicker, better responses as a first therapy for many patients.
Separate international Phase III clinical trials compared high-quality remissions after one year of treatment between the standard-of-care drug Gleevec and the two second-line drugs. In both trials, previously untreated CML patients who took the newer drugs reached complete cytogenetic response and major molecular response — two important measures of remission — faster than those taking Gleevec. These patients were also less likely to have their disease progress to advanced stages.
“We’ve learned in cancer therapy that it’s important to use your big guns up front,” says Hagop Kantarjian, M.D., professor and chair of MD Anderson’s Department of Leukemia, as well as corresponding author on both the dasatinib and nilotinib studies. “We know that achieving complete cytogenetic response or major molecular response within a year of starting treatment is associated with more favorable long-term survival. Using these second-generation drugs first will likely improve outcomes for patients with CML.”
Reported in the June online edition of the New England Journal of Medicine and at the 2010 annual meeting of the American Society of Clinical Oncology.