Abstract | BACKGROUND:
Dasatinib, a highly potent BCR-ABL inhibitor, is an effective treatment for patients with chronic myeloid leukemia in chronic phase (CML CP) after resistance, suboptimal response, or intolerance to prior imatinib. In a phase 3 dose optimization trial in patients with CML CP (CA180-034), the occurrence of pleural effusion was significantly minimized with dasatinib 100 mg once daily (QD) compared with other treatment arms (70 mg twice daily [twice daily], 140 mg QD, or 50 mg twice daily). METHODS: RESULTS: With 24-month minimum follow-up, 14% of patients treated with dasatinib 100 mg QD incurred pleural effusion (grade 3: 2%; grade 4: 0%) compared with 23% to 26% in other study arms. The pleural effusion rate showed only a minimal increment from 12 to 24 months. In the 100 mg QD study arm, median time to pleural effusion (any grade) was 315 days, and after pleural effusion, 52% of patients had a transient dose interruption, 35% had a dose reduction, 57% received a diuretic, and 26% received a corticosteroid. Three patients in the 100 mg QD study arm discontinued treatment after pleural effusion. Across all study arms, patients with or without pleural effusion demonstrated similar progression-free and overall survival, and cytogenetic response rates were higher in patients with a pleural effusion. CONCLUSIONS:
Pleural effusion is minimized with dasatinib 100 mg QD dosing and its occurrence does not affect short- or long-term efficacy.
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Authors | Kimmo Porkka, H Jean Khoury, Ronald L Paquette, Yousif Matloub, Ritwik Sinha, Jorge E Cortes |
Journal | Cancer
(Cancer)
Vol. 116
Issue 2
Pg. 377-86
(Jan 15 2010)
ISSN: 0008-543X [Print] United States |
PMID | 19924787
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antineoplastic Agents
- Protein Kinase Inhibitors
- Pyrimidines
- Thiazoles
- Dasatinib
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Topics |
- Adult
- Aged
- Antineoplastic Agents
(administration & dosage)
- Dasatinib
- Drug Administration Schedule
- Female
- Humans
- Leukemia, Myeloid, Chronic-Phase
(complications, drug therapy, genetics)
- Middle Aged
- Pleural Effusion
(complications, prevention & control, therapy)
- Protein Kinase Inhibitors
(administration & dosage)
- Pyrimidines
(administration & dosage)
- Risk Factors
- Thiazoles
(administration & dosage)
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