Comparing nilotinib and dasatinib as second line treatment in patients with chronic myeloid leukemia in a real-life setting

This study aimed to compare dasatinib (Sprycel) and nilotinib (Tasigna) as second-line treatments for patients with chronic-phase (CP) chronic myeloid leukemia (CML) in a real-life setting.  

This study concluded that both dasatinib and nilotinib are equally effective and well tolerated as second-line treatments in these patients. 

Tyrosine kinase inhibitors (TKIs) are a type of targeted therapy and are important pillars in the treatment of CP-CML. TKIs have changed the long-term outcomes of these patients. Imatinib (Gleevec) is a first-generation TKI. It is usually the first-line treatment for patients with CP-CML. However, some patients do not tolerate it or fail to respond to imatinib. Second-generation TKIs such as dasatinib and nilotinib have been developed for these patients. 

Previous clinical trials have shown that both dasatinib and nilotinib are effective and safe as second-line therapies for patients with CP-CML. However, patients in clinical trials are carefully selected to be young, fit, and without significant medical conditions. Therefore, it was unknown if dasatinib or nilotinib are effective and safe as a second-line treatment for patients with CP-CML in a real-life setting. 

This study involved 131 patients with CP-CML who previously failed front-line imatinib treatment. 44.3% of patients then received nilotinib and 55.7% received dasatinib as a second-line treatment. The average duration of second-line treatment was 33 months.  

The 7-year overall survival (OS) rate of all patients was 78.9%. This rate was 72% for the group treated with dasatinib and 85.6% for the group treated with nilotinib. This difference was not considered statistically significant.

After 12 months, 47% of patients treated with dasatinib achieved a major molecular response (MMR) compared to 38% of those treated with nilotinib. MMR is when there is a low level of the cancer gene BCR-ABL present. 18.2% of patients treated with dasatinib had a deep molecular response (DMR) compared to 16.2% of patients treated with nilotinib. DMR is a sign of disease remission. 

Patients in the dasatinib group reported severe side effects more commonly (71%) than the nilotinib group (29%). 

This study concluded that both dasatinib and nilotinib were equally effective and well tolerated as second-line treatments in patients with CP-CML in a real-life setting. 

This study had a small number of participants. Medical records were used for this study. Therefore, information about patients might have been missing.