Dasatinib: a once-daily option for imatinib-resistant CML

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Dasatinib [Sprycel], an oral inhibitor of multiple tyrosine kinases, is approved for the treatment of adults in all phases of chronic myeloid leukaemia (CML) who have experienced resistance or intolerance to prior therapy, including imatinib [Gleevec]. A phase III study presented at the 48th Annual Meeting and Exposition of the American Society of Hematology (ASH) [Orlando, Florida, US; December 2006] showed that in patients with chronic-phase CML who were intolerant or resistant to imatinib, treatment with dasatinib 100mg once daily provided similar efficacy to the US FDA-approved dosing regimen of 70mg twice daily, with an improved tolerability profile. The major cytogenetic response rates at 6 months were comparable between the once-daily and twice-daily dosing regimens; however, compared with dasatinib 70mg twice daily, dasatinib 100mg once daily was associated with significantly lower incidences of grade 3 or 4 haematological toxicities, including thrombocytopenia, anaemia, and neutropenia. A phase II study in patients with imatinib-resistant, chronic-phase CML showed that dasatinib provided significant benefits for major and complete cytogenetic responses, major molecular response, and progression-free survival, compared with an escalated dose of imatinib.

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