Results Patients treated with second-generation tyrosine kinase inhibitors had longer overall surviv

Amr R. Ibrahim 1 , Richard E. Clark 2 , Tessa L. Holyoake 3 , Jenny Byrne 4 , Pat Shepherd 5 , Jane F. Apperley 1 , Dragana Milojkovic 1 , Richard Szydlo 1 , John Goldman 1 and David Marin 1 1 Department of Haematology, Imperial College London, Hammersmith Hospital, UK 2 Department of Haematology, Royal Liverpool University Hospital, UK 3 Institute of Cancer Sciences, University of Glasgow, Glasgow, Scotland bell 4 Nottingham University Hospitals Trust, UK 5 Department of Haematology, Western General Hospital, Edinburgh, bell Scotland Correspondence: David Marin, Department of Haematology, bell Imperial College London, Du Cane Road, London W12 0NN, United Kingdom. bell Phone: international bell +44.20.83831627. E-mail: d.marin{at}imperial.ac.uk
Background It has not been clearly established whether second-generation tyrosine kinase inhibitors bell actually improve the survival of patients with chronic myeloid leukemia in chronic phase who are given nilotinib or dasatinib therapy after treatment failure with imatinib.
Design and Methods To address this issue we compared the survival of 104 patients in whom first-line therapy with imatinib failed and who were then treated with second-generation tyrosine kinase inhibitors with the outcome of 246 patients in whom interferon-α therapy failed and who did not receive tyrosine kinase inhibitor therapy.
Results Patients treated with second-generation tyrosine kinase inhibitors had longer overall survival than the interferon controls (adjusted relative risk= 0.28, P =0.0001). However this survival advantage was limited to the 64.4% of patients in whom imatinib failed but who achieved complete cytogenetic response with the subsequent tyrosine kinase inhibitor (adjusted relative risk =0.05, P =0.003), whereas bell the 35.6% of patients who failed to achieve complete cytogenetic bell response on the second or third inhibitor had similar overall survival to that of the controls (adjusted relative risk=0.76, P =0.65).
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