In a nutshell
This study compared side effects between two similar therapies – nilotinib (Tasigna) and dasatinib (Sprycel) – for chronic myeloid leukemia (CML). Researchers reported more serious side effects with dasatinib than with nilotinib.
Tyrosine kinase inhibitor (TKI) therapy is a standard first-line treatment for CML. TKIs works by blocking enzymes called tyrosine kinases involved in leukemia cell growth. Nilotinib and dasatinib are two second-generation TKIs, which means they were more recently developed. They have been associated with similar effectiveness and are approved for the first- and second-line treatment of CML. More studies are needed to compare the rate of side effects between nilotinib and dasatinib. This is important for decisions such as stopping or switching treatment.
Methods & findings
201 patients with chronic (early) phase CML were included. 120 patients received nilotinib and 81 received dasatinib as either a first- or second-line treatment. Side effects were compared between the two treatment groups. Patients were followed for an average of 37 months.
Serious side effects were significantly more common in the dasatinib group (54%) compared to the nilotinib group (22%). Changes in dosage and stopping treatment due to side effects were also more common with dasatinib.
Pleural effusion (excess fluid build-up around the lung) occurred in 35% of patients treated with dasatinib. One patients receiving dasatinib experienced a narrowing of blood vessels connected to the lungs due to treatment. Side effects related to the heart and blood vessels (such as stroke) were more common in patients treated with nilotinib (reported in 5% of patients).
Major molecular response (MMR; showing very few genetic abnormalities in the blood or bone marrow) is often the treatment goal for CML. Among patients treated with nilotinib, MMR was 75% for first-line therapy and 85% for second-line therapy. Among patients treated with dasatinib, MMR was 68% for first-line therapy and 70% for second-line therapy. The average time until complications or events such as disease progression was significantly longer with nilotinib than with dasatinib.
The bottom line
This study found that side effects and discontinuing TKI therapy were more common with dasatinib than with nilotinib.
The fine print
This study followed patients for an average of 37 months. Some side effects may appear later.
Published By :
International journal of hematology
Aug 09, 2017