Comparison of the Efficacy Among Nilotinib, Dasatinib, Flumatinib and Imatinib in Newly Diagnosed Chronic-Phase Chronic Myeloid Leukemia Patients: A Real-World Multi-Center Retrospective Study

被引：3

作者：

Zhang, Xiaoshuai ^{[1
]}

Xu, Na ^{[2
]}

Yang, Yunfan ^{[3
]}

Lin, Hai ^{[4
]}

Liu, Bingcheng ^{[5
]}

Du, Xin ^{[6
]}

Liu, Xiaoli ^{[2
]}

Liang, Rong ^{[7
]}

Chen, Chunyan ^{[8
]}

Huang, Jian ^{[9
]}

Zhu, Huanling ^{[3
]}

Pan, Ling ^{[3
]}

Wang, Xiaodong ^{[10
]}

Li, Guohui ^{[11
]}

Liu, Zhuogang ^{[12
]}

Zhang, Yanqing ^{[13
]}

Liu, Zhenfang ^{[14
]}

Hu, Jianda ^{[15
]}

Liu, Chunshui ^{[4
]}

Li, Fei ^{[16
]}

Yang, Wei ^{[12
]}

Meng, Li ^{[17
]}

Han, Yanqiu ^{[18
]}

Lin, Li'e ^{[19
]}

Zhao, Zhenyu ^{[19
]}

Tu, Chuanqing ^{[20
]}

Zheng, Caifeng ^{[20
]}

Bai, Yanliang ^{[21
,22
]}

Zhou, Zeping ^{[23
]}

Chen, Suning ^{[24
]}

Qiu, Huiying ^{[24
]}

Yang, Lijie ^{[11
]}

Sun, Xiuli ^{[25
]}

Sun, Hui ^{[26
]}

Zhou, Li ^{[27
]}

Liu, Zelin ^{[28
]}

Wang, Danyu ^{[28
]}

Guo, Jianxin ^{[29
]}

Pang, Liping ^{[30
]}

Zeng, Qingshu ^{[31
]}

Suo, Xiaohui ^{[32
]}

Zhang, Weihua ^{[33
]}

Zheng, Yuanjun ^{[33
]}

Zhang, Yanli ^{[34
]}

Li, Weiming ^{[35
]}

Jiang, Qian ^{[1
,36
]}

机构：

[1] Peking Univ Peoples Hosp, Inst Hematol, Natl Clin Res Ctr Hematol Dis, Beijing Key Lab Hematopoiet Stem Cell Transplantat, 11 Xizhimen South St, Beijing 100044, Peoples R China

[2] Southern Med Univ, Nanfang Hosp, Dept Hematol, Guangzhou, Peoples R China

[3] Sichuan Univ, West China Hosp, Inst Hematol, Dept Hematol, Chengdu, Sichuan, Peoples R China

[4] First Hosp Jilin Univ, Dept Hematol, Jilin, Peoples R China

[5] Chinese Acad Med Sci & Peking Union Med Coll, Inst Hematol & Blood Dis Hosp, Natl Clin Res Ctr Blood Dis, Tianjin, Peoples R China

[6] Shenzhen Univ, Peoples Hosp Shenzhen 2, Affiliated Hosp 1, Dept Hematol, Shenzhen, Peoples R China

[7] Airforce Mil Med Univ, Xijing Hosp, Dept Hematol, Xian, Peoples R China

[8] Shandong Univ, Qilu Hosp, Dept Hematol, Jinan, Peoples R China

[9] Zhejiang Univ, Affiliated Hosp 4, Zhejiang Prov Clin Res Ctr Haematol Disorders, Coll Med,Affiliated Hosp 1,Dept Hematol, Hangzhou, Zhejiang, Peoples R China

[10] Sichuan Acad Med Sci, Sichuan Prov Peoples Hosp, Dept Hematol, Chengdu, Sichuan, Peoples R China

[11] Xian Int Med Ctr Hosp, Dept Hematol, Xian, Peoples R China

[12] China Med Univ, Shengjing Hosp, Dept Hematol, Shenyang, Peoples R China

[13] Harbin Med Univ, Affiliated Hosp 2, Dept Hematol, Harbin, Peoples R China

[14] Guangxi Med Univ, Affiliated Hosp 1, Dept Hematol, Nanning, Guangxi, Peoples R China

[15] Fujian Med Univ, Union Hosp, Dept Hematol, Fuzhou, Fujian, Peoples R China

[16] Nanchang Univ, Affiliated Hosp 1, Ctr Hematol, Nanchang, Peoples R China

[17] Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Hematol, Tongji Hosp, Wuhan, Peoples R China

[18] Inner Mongolia Med Univ, Affiliated Hosp, Dept Hematol, Hohhot, Inner Mongolia, Peoples R China

[19] Hainan Gen Hosp, Dept Hematol, Hainan, Peoples R China

[20] Shenzhen Univ, Shenzhen Baoan Hosp, Affiliated Hosp 2, Dept Hematol, Shenzhen, Peoples R China

[21] Henan Prov Peoples Hosp, Dept Hematol, Zhengzhou, Henan, Peoples R China

[22] Zhengzhou Univ, Peoples Hosp, Zhengzhou, Henan, Peoples R China

[23] Kunming Med Univ, Hosp Affiliated 2, Dept Hematol, Kunming, Peoples R China

[24] Soochow Univ, Jiangsu Inst Hematol, Inst Blood & Marrow Transplantat, Natl Clin Res Ctr Hematol Dis,Affiliated Hosp 1, Suzhou, Peoples R China

[25] Dalian Med Univ, Affiliated Hosp 1, Dept Hematol, Dalian, Peoples R China

[26] Zhengzhou Univ, Affiliated Hosp 1, Dept Hematol, Zhengzhou, Peoples R China

[27] Shanghai Jiao Tong Univ, Ruijin Hosp, Shanghai Inst Hematol, Natl Res Ctr Translat Med Shanghai,Sch Med, Shanghai, Peoples R China

[28] Huazhong Univ Sci & Technol, Union Shenzhen Hosp, Nanshan Hosp, Dept Hematol, Shenzhen, Peoples R China

[29] Fujian Med Univ, Affiliated Hosp 2, Dept Hematol, Fuzhou, Fujian, Peoples R China

[30] Peking Univ, Shenzhen Hosp, Dept Hematol, Shenzhen, Peoples R China

[31] Anhui Med Univ, Affiliated Hosp 1, Dept Hematol, Hefei, Anhui, Peoples R China

[32] Handan Cent Hosp, Dept Hematol, Handan, Peoples R China

[33] Shanxi Med Univ, Hosp 1, Dept Hematol, Jinzhong, Shanxi, Peoples R China

[34] Zhengzhou Univ, Henan Canc Hosp, Affiliated Canc Hosp, Dept Hematol, 127 Dongming Rd, Zhengzhou 450000, Henan, Peoples R China

[35] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Hematol, 1277 Jiefang Ave, Wuhan 430022, Peoples R China

[36] Peking Univ Peoples Hosp, Qingdao, Peoples R China

来源：

CLINICAL LYMPHOMA MYELOMA & LEUKEMIA | 2024年 / 24卷 / 06期

基金：

中国国家自然科学基金;

关键词：

CML; Outcomes; Propensity-score matching (PSM); Second-generation tyrosine-kinase inhibitor (2G-TKI); Therapy responses; KINASE DOMAIN MUTATIONS; RECOMMENDATIONS; MANAGEMENT; SPECTRUM;

D O I：

10.1016/j.clml.2024.02.008

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

This real -world multi -center retrospective study indicated nilotinib, dasatinib and flumatinib had comparable efficacy and significantly higher therapy responses rates and higher FFS rates than imatinib in newly diagnosed chronic phase chronic myeloid leukemia patients. However, there were no significant differences in PFS and OS among these 4 TKIs. These real -world data may provide additional evidence for routine clinical assessments to identify more appropriate therapies. Background: There are limited data comprehensively comparing therapy responses and outcomes among nilotinib, dasatinib, flumatinib and imatinib for newly diagnosed chronic-phase chronic myeloid leukemia in a real-world setting. Patients and Methods: Data from patients with chronic-phase CML receiving initial a second-generation tyrosine-kinase inhibitor (2G-TKI, nilotinib, dasatinib or flumatinib) or imatinib therapy from 77 Chinese centers were retrospectively interrogated. Propensity-score matching (PSM) analyses were performed to to compare therapy responses and outcomes among these 4 TKIs. Results: 2,496 patients receiving initial nilotinib (n = 512), dasatinib (n = 134), flumatinib (n = 411) or imatinib (n = 1,439) therapy were retrospectively interrogated in this study. PSM analyses indicated that patients receiving initial nilotinib, dasatinib or flumatinib therapy had comparable cytogenetic and molecular responses (p = .28-.91) and survival outcomes including failure-free survival (FFS, p = .28-.43), progression-free survival (PFS, p = .19-.93) and overall survival (OS) (p values = .76-.78) but had significantly higher cumulative incidences of cytogenetic and molecular responses (all p values < .001) and higher probabilities of FFS (p < .001-.01) than those receiving imatinib therapy, despite comparable PFS (p = .18-.89) and OS (p = .23-.30). Conclusion: Nilotinib, dasatinib and flumatinib had comparable efficacy, and significantly higher therapy responses and higher FFS rates than imatinib in newly diagnosed CML patients. However, there were no significant differences in PFS and OS among these 4 TKIs. These real-world data may provide additional evidence for routine clinical assessments to identify more appropriate therapies.

引用

页码：e257 / e266

页数：10

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