PMID- 30288121
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 1179-1322 (Print)
IS  - 1179-1322 (Electronic)
IS  - 1179-1322 (Linking)
VI  - 10
DP  - 2018
TI  - First-line treatment strategies for newly diagnosed chronic myeloid leukemia: a 
      network meta-analysis.
PG  - 3891-3910
LID - 10.2147/CMAR.S177566 [doi]
AB  - OBJECTIVES: With bosutinib proven to be available for frontline treatment, there 
      are currently four frontline treatments as well as an additional strategy with 
      high-dose imatinib for newly diagnosed chronic myeloid leukemia (CML). Due to the 
      lack of direct comparison of high-dose imatinib, dasatinib, nilotinib, and 
      bosutinib, we summarized the evidence to indirectly compare the efficacy among 
      these treatment options. METHODS: In total, 14 randomized clinical trials 
      including 5,630 patients were analyzed by direct and mixed-treatment comparisons. 
      Outcomes assessed were the following: complete cytogenetic response at 12 months; 
      major molecular response at 12, 24, and 36 months; deep molecular response at 12, 
      24, 36, and 60 months; early molecular response at 3 months; progression-free 
      survival (PFS); overall survival (OS); and Grade 3 or 4 adverse events (AEs). 
      RESULTS: The Bayesian network meta-analysis demonstrated that high-dose imatinib 
      was less effective than all new-generation tyrosine kinase inhibitors and had a 
      higher probability of Grade 3 or 4 AEs. For molecular response, 300 mg of 
      nilotinib was likely to be the preferred frontline treatment, as demonstrated by 
      higher response rates and faster, deeper, and longer molecular response. For PFS 
      and OS, there were high likelihoods (79% and 74%, respectively) that 400 mg of 
      nilotinib was the preferred option. For AEs, standard-dose imatinib has the 
      highest probability (65%) of being the most favorable toxicity profile. 
      CONCLUSION: Considering the efficacy and toxicity profile, it is not recommended 
      to use high-dose imatinib for treatment. This analysis also showed that nilotinib 
      has the highest probability to become the preferred frontline agents for treating 
      CML.
FAU - Chen, Kang-Kang
AU  - Chen KK
AD  - Department of Preventive Medicine and MPH Education Center, Shantou University 
      Medical College, Shantou, Guangdong Province, China.
FAU - Du, Tai-Feng
AU  - Du TF
AD  - Department of Preventive Medicine and MPH Education Center, Shantou University 
      Medical College, Shantou, Guangdong Province, China.
FAU - Wu, Ku-Sheng
AU  - Wu KS
AD  - Department of Preventive Medicine, Shantou University Medical College, Shantou, 
      Guangdong Province, China.
FAU - Yang, Wei
AU  - Yang W
AD  - Department of Thoracic Surgery, Administrative Office, Shantou University Medical 
      College Cancer Hospital, Shantou, Guangdong Province, China, yangwei_98@sina.com.
LA  - eng
PT  - Journal Article
DEP - 20180925
PL  - New Zealand
TA  - Cancer Manag Res
JT  - Cancer management and research
JID - 101512700
PMC - PMC6163008
OTO - NOTNLM
OT  - CML
OT  - bosutinib
OT  - dasatinib
OT  - imatinib
OT  - nilotinib
OT  - tyrosine kinase inhibitor
COIS- Disclosure The authors report no conflicts of interest in this work.
EDAT- 2018/10/06 06:00
MHDA- 2018/10/06 06:01
PMCR- 2018/09/25
CRDT- 2018/10/06 06:00
PHST- 2018/10/06 06:00 [entrez]
PHST- 2018/10/06 06:00 [pubmed]
PHST- 2018/10/06 06:01 [medline]
PHST- 2018/09/25 00:00 [pmc-release]
AID - cmar-10-3891 [pii]
AID - 10.2147/CMAR.S177566 [doi]
PST - epublish
SO  - Cancer Manag Res. 2018 Sep 25;10:3891-3910. doi: 10.2147/CMAR.S177566. 
      eCollection 2018.