PMID- 28378056
OWN - NLM
STAT- MEDLINE
DCOM- 20171005
LR  - 20220114
IS  - 1865-3774 (Electronic)
IS  - 0925-5710 (Linking)
VI  - 106
IP  - 2
DP  - 2017 Aug
TI  - Analysis of adverse events associated with dasatinib and nilotinib treatments in 
      chronic-phase chronic myeloid leukemia patients outside clinical trials.
PG  - 229-239
LID - 10.1007/s12185-017-2225-1 [doi]
AB  - We analyzed adverse events (AEs) in 201 chronic phase CML patients treated with 
      nilotinib (n = 120) or dasatinib (n = 81) as first- or second-line therapy. The 
      dasatinib group had significantly higher grade 3-4 AEs compared to the nilotinib 
      group (22 vs. 54%, p < 0.001), and had more frequent dose reduction, 
      interruption, and discontinuation (p < 0.001, p = 0.004, and p = 0.006, 
      respectively). Of 59 patients who discontinued treatment, 47 (80%) discontinued 
      treatment due to AEs; 50% of the AEs causing drug discontinuation were of grade 2 
      severity. Compared to the second-line setting, discontinuation occurred more 
      rapidly in the first-line setting (2.9 vs. 15.6 months, p = 0.015). Pleural 
      effusion occurred in 35% (28/81) of the patients with dasatinib and led to 
      dasatinib discontinuation in 14 patients (grade 2 of 79%). Pulmonary artery 
      hypertension occurred in one patient with dasatinib. Stroke, acute coronary 
      syndrome, and peripheral artery occlusive disease occurred in 5% (6/120) of the 
      patients treated with nilotinib. The dasatinib group had shorter event-free 
      survival than nilotinib group (first-line, p = 0.051; second-line, p = 0.025). In 
      the clinical practice setting, nilotinib or dasatinib use was more frequently 
      interrupted than recommended by guidelines in association with less severe AEs. 
      We believe this phenomenon is attributable to the availability of other TKIs.
FAU - Suh, Koung Jin
AU  - Suh KJ
AD  - Department of Internal Medicine, Seoul National University Bundang Hospital, 
      Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-Si, Gyeonggi-di, 13620, Korea.
AD  - Department of Internal Medicine, Seoul National University Hospital, Seoul 
      National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, 
      Korea.
FAU - Lee, Ji Yun
AU  - Lee JY
AD  - Department of Internal Medicine, Seoul National University Bundang Hospital, 
      Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-Si, Gyeonggi-di, 13620, Korea.
FAU - Shin, Dong-Yeop
AU  - Shin DY
AD  - Department of Internal Medicine, Seoul National University Hospital, Seoul 
      National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, 
      Korea.
AD  - Cancer Research Institute, Seoul National University College of Medicine, Seoul, 
      Korea.
FAU - Koh, Youngil
AU  - Koh Y
AD  - Department of Internal Medicine, Seoul National University Hospital, Seoul 
      National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, 
      Korea.
AD  - Cancer Research Institute, Seoul National University College of Medicine, Seoul, 
      Korea.
FAU - Bang, Soo-Mee
AU  - Bang SM
AD  - Department of Internal Medicine, Seoul National University Bundang Hospital, 
      Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-Si, Gyeonggi-di, 13620, Korea.
FAU - Yoon, Sung-Soo
AU  - Yoon SS
AD  - Department of Internal Medicine, Seoul National University Hospital, Seoul 
      National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, 
      Korea.
AD  - Cancer Research Institute, Seoul National University College of Medicine, Seoul, 
      Korea.
FAU - Park, Seonyang
AU  - Park S
AD  - Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, 
      Korea.
FAU - Kim, Inho
AU  - Kim I
AD  - Department of Internal Medicine, Seoul National University Hospital, Seoul 
      National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, 
      Korea. ihkimmd@snu.ac.kr.
AD  - Cancer Research Institute, Seoul National University College of Medicine, Seoul, 
      Korea. ihkimmd@snu.ac.kr.
FAU - Lee, Jeong-Ok
AU  - Lee JO
AUID- ORCID: 0000-0001-9402-6372
AD  - Department of Internal Medicine, Seoul National University Bundang Hospital, 
      Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-Si, Gyeonggi-di, 13620, Korea. 
      jeongok77@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20170404
PL  - Japan
TA  - Int J Hematol
JT  - International journal of hematology
JID - 9111627
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 0 (Pyrimidines)
RN  - EC 2.7.10.1 (Protein-Tyrosine Kinases)
RN  - F41401512X (nilotinib)
RN  - RBZ1571X5H (Dasatinib)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Agents/*adverse effects
MH  - Clinical Trials as Topic
MH  - Dasatinib/*adverse effects
MH  - Deprescriptions
MH  - Female
MH  - Humans
MH  - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/*drug therapy/mortality
MH  - Male
MH  - Middle Aged
MH  - Pleural Effusion/*chemically induced/epidemiology
MH  - Practice Guidelines as Topic
MH  - Protein Kinase Inhibitors/*adverse effects
MH  - Protein-Tyrosine Kinases/antagonists & inhibitors
MH  - Pyrimidines/*adverse effects
MH  - Survival Rate
MH  - Vascular Diseases/chemically induced/epidemiology
MH  - Young Adult
OTO - NOTNLM
OT  - Dasatinib
OT  - Discontinuation
OT  - Nilotinib
OT  - Pleural effusion
OT  - Toxicity
EDAT- 2017/04/06 06:00
MHDA- 2017/10/06 06:00
CRDT- 2017/04/06 06:00
PHST- 2016/12/12 00:00 [received]
PHST- 2017/03/30 00:00 [accepted]
PHST- 2017/03/27 00:00 [revised]
PHST- 2017/04/06 06:00 [pubmed]
PHST- 2017/10/06 06:00 [medline]
PHST- 2017/04/06 06:00 [entrez]
AID - 10.1007/s12185-017-2225-1 [pii]
AID - 10.1007/s12185-017-2225-1 [doi]
PST - ppublish
SO  - Int J Hematol. 2017 Aug;106(2):229-239. doi: 10.1007/s12185-017-2225-1. Epub 2017 
      Apr 4.