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

• DOI: 10.1016/j.clml.2024.02.008
• Publication Date: 2024-02-15T10:05:26Z
• Authors: Xiaoshuai Zhang; Na Xu; Yunfan Yang; Hai Lin; Bingcheng Liu; Xin Du; Xiaoli Liu; Rong Liang; Chunyan Chen; Jian Huang; Huanling Zhu; Ling Pan; Xiaodong Wang; Guohui Li; Zhuogang Liu; Yanqing Zhang; Zhenfang Liu; Jianda Hu; Chunshui Liu; Fei Li; Wei Yang; Li Meng; Yanqiu Han; Li'e Lin; Zhenyu Zhao; Chuanqing Tu; Caifeng Zheng; Yanliang Bai; Zeping Zhou; Suning Chen; Huiying Qiu; Lijie Yang; Xiuli Sun; Hui Sun; Li Zhou; Zelin Liu; Danyu Wang; Jianxin Guo; Liping Pang; Qingshu Zeng; Xiaohui Suo; Weihua Zhang; Yuanjun Zheng; Yanli Zhang; Weiming Li; Qian Jiang
• Keywords: Male; Adult; Aged, 80 and over; Adolescent; Dasatinib; Aminopyridines; Middle Aged; Young Adult; Pyrimidines; Treatment Outcome; Leukemia, Myeloid, Chronic-Phase; Benzamides; Imatinib Mesylate; Humans; Female; Protein Kinase Inhibitors; Retrospective Studies; Aged

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.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.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).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.