ASH2010慢性髓性白血病12-10-2幻灯片.pptVIP

慢性髓性白血病研究进展--第52届ASH会议重点解读 December 4-7, 2010 Orlando, FL 伊马替尼（400mg/d）是初诊CML慢性期患者的标准治疗 IRIS 8年随访结果EFS、无加速/急变生存率分别是82%、92% TKI治疗大大降低CML死亡率 部分患者仍存在耐药和疾病进展 第二代TKI治疗伊马替尼耐药的CML-CP患者，仅50%获CCyR，加速期患者获得CCyR率更低 The Phase 3 DASISION study compares dasatinib with imatinib as initial treatment for pts with newly diagnosed CML-CP. Eighteen-mo follow-up data are presented here 519 pts with newly diagnosed CML-CP (median disease duration of 1 mo) stratified by Hasford risk were randomized to either dasatinib 100 mg once daily (n = 259), or imatinib 400 mg once daily (n = 260). After 18 mos of follow-up, dasatinib 100 mg once daily continues to demonstrate superior efficacy compared to imatinib. Dasatinib also continues to be generally well tolerated. These results support the potential use of dasatinib as initial treatment for pts with newly diagnosed CML-CP. With a median follow-up of 18 months, the overall best MMR rate was superior for nilotinib 300 mg bid (66%, P .0001) and nilotinib 400 mg bid (62%, P .0001) compared with imatinib (40%). Superior rates of MMR were observed in both nilotinib arms compared with the imatinib arm across all Sokal risk groups (Table). The overall best rate of BCR-ABLIS ? 0.0032% (equivalent to complete molecular response, CMR) was superior for nilotinib 300 mg bid (21%, P .0001) and nilotinib 400 mg bid (17%, P .0001) compared with imatinib (6%). The overall best CCyR rate was superior for nilotinib 300 mg bid (85%, P .001) and nilotinib 400 mg bid (82%, P = .017) compared with imatinib (74%). The superior efficacy of nilotinib was further demonstrated using the 2009 European LeukemiaNet (ELN) 12-month milestone in which fewer patients had suboptimal response or treatment failure on nilotinib 300 mg bid (2%, 3%) and nilotinib 400 mg bid (2%, 2%) vs imatinib (11%, 8%). Rates of progression to AP/BC on treatment were significantly lower for nilotinib 300 mg bid (0.7%, P = .006) and nilotinib 400 mg bid (0.4%, P = .003) compared with