Publication details

Final 5-Year Study Results of DASISION: The Dasatinib Versus Imatinib Study in Treatment-Naive Chronic Myeloid Leukemia Patients Trial

Authors

CORTES Jorge E. SAGLIO Giuseppe KANTARJIAN Hagop M. BACCARANI Michele MAYER Jiří BOQUÉ Concepción SHAH Neil P. CHUAH Charles CASANOVA Luis BRADLEY-GARELIK Brigid MANOS George HOCHHAUS Andreas

Year of publication 2016
Type Article in Periodical
Magazine / Source Journal of Clinical Oncology
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1200/JCO.2015.64.8899
Field Oncology and hematology
Keywords TYROSINE KINASE INHIBITORS; EARLY MOLECULAR RESPONSE; CHRONIC MYELOGENOUS LEUKEMIA; BCR-ABL1 TRANSCRIPT LEVELS; CHRONIC-PHASE; EUROPEAN-LEUKEMIANET; SUBOPTIMAL RESPONSE; INTERFERON-ALPHA; FOLLOW-UP; THERAPY
Attached files
Description Purpose We report the 5-year analysis from the phase III Dasatinib Versus Imatinib Study in Treatment-Naive Chronic Myeloid Leukemia Patients (DASISION) trial, evaluating long-term efficacy and safety outcomes of patients with chronic myeloid leukemia (CML) in chronic phase (CP) treated with dasatinib or imatinib. Patients and Methods Patients with newly diagnosed CML-CP were randomly assigned to receive dasatinib 100 mg once daily (n = 259) or imatinib 400 mg once daily (n = 260). Results At the time of study closure, 61% and 63% of dasatinib- and imatinib-treated patients remained on initial therapy, respectively. Cumulative rates of major molecular response and molecular responses with a 4.0- or 4.5-log reduction in BCR-ABL1 transcripts from baseline by 5 years remained statistically significantly higher for dasatinib compared with imatinib. Rates for progression-free and overall survival at 5 years remained high and similar across treatment arms. In patients who achieved BCR-ABL1 <= 10% at 3 months (dasatinib, 84%; imatinib, 64%), improvements in progression-free and overall survival and lower rates of transformation to accelerated/blast phase were reported compared with patients with BCR-ABL1 greater than 10% at 3 months. Transformation to accelerated/blast phase occurred in 5% and 7% of patients in the dasatinib and imatinib arms, respectively. Fifteen dasatinib-treated and 19 imatinib-treated patients had BCR-ABL1 mutations identified at discontinuation. There were no new or unexpected adverse events identified in either treatment arm, and pleural effusion was the only drug-related, nonhematologic adverse event reported more frequently with dasatinib (28% v 0.8% with imatinib). First occurrences of pleural effusion were reported with dasatinib, with the highest incidence in year 1. Arterial ischemic events were uncommon in both treatment arms. Conclusion These final results from the DASISION trial continue to support dasatinib 100 mg once daily as a safe and effective first-line therapy for the long-term treatment of CML-CP.

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