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Bosutinib shows low cross intolerance, in chronic myeloid leukemia patients treated in fourth line. Results of the S panish compassionate use program

2015; Wiley; Volume: 90; Issue: 5 Linguagem: Inglês

10.1002/ajh.23973

1096-8652

Valentín García‐Gutiérrez, Alejandra Martínez‐Trillos, José Luis López Lorenzo, Guiomar Bautista, María Luisa Martín Mateos, Alberto Álvarez‐Larrán, Ana Iglesias Pérez, Andrés Romo Collado, Ángeles Fernández, Angeles Portero, Beatriz Cuevas, Concepción Ruíz, Esperanza Romero, Fernando Ramos Ortega, Isabel Mata, J. Ríos Tallón, María del Carmen García Garay, María José Ramirez Sánchez, Natalia de las Heras, Pilar Giraldo, Sabela Bobillo, José María Guinea de Castro, Guillermo Debén, Sandra Elizabeth Villacís Valencia, Ana Sebrango, Concepción Boqué, Begoña Maestro, Juan Luis Steegmann,

Eosinophilic Disorders and Syndromes

The role of bosutinib as rescue treatment of Philadelphia chromosome-positive chronic myeloid leukemia (CML) patients after failing three previous tyrosine kinase inhibitors (TKIs) is currently unknown. We report here the largest series (to our knowledge) of patients treated with bosutinib in fourth-line, after retrospectively reviewing 30 patients in chronic phase, and pretreated with imatinib, nilotinib, and dasatinib. With a median follow up of 11.1 months, the probability to either maintain or improve their CCyR response was 56.6% (17/30) and 11 patients (36.7%) achieved or maintained their baseline MMR. In patients not having baseline CCyR, the probabilities of obtaining CCyR, MMR, and MR4.5 were 13, 11, and 14%, respectively. The probabilities of obtaining MMR and deep molecular response MR4.5 in patients with baseline CCyR were 40.0% (6/15) and 20.0% (3/15). At 20 months, progression-free survival was 73%. Grade 3-4 hematological toxicities were more frequent in resistant than intolerant patients (45.4 vs. 0.0%). Nonhematological toxicities were also more frequent in resistant patients, being diarrhea the most conspicuous one. Bosutinib seems to be an appropriate treatment option for patients resistant or intolerant to three prior TKI's.