PMID- 30587215 OWN - NLM STAT- MEDLINE DCOM- 20200109 LR - 20200309 IS - 1756-8722 (Electronic) IS - 1756-8722 (Linking) VI - 11 IP - 1 DP - 2018 Dec 27 TI - Management of adverse events associated with bosutinib treatment of chronic-phase chronic myeloid leukemia: expert panel review. PG - 143 LID - 10.1186/s13045-018-0685-2 [doi] LID - 143 AB - Bosutinib, a BCR-ABL1 tyrosine kinase inhibitor (TKI), has been available for several years as a treatment for chronic-, accelerated-, and blast-phase chronic myeloid leukemia (CML), for patients with resistance or intolerance to prior therapy. In 2017, the BFORE trial demonstrated efficacy of bosutinib as first-line treatment in adult patients with newly diagnosed chronic-phase chronic myeloid leukemia (CP-CML). The most common adverse events (AEs) of any grade in bosutinib-treated patients in BFORE were diarrhea, nausea, thrombocytopenia, increased alanine aminotransferase, and increased aspartate aminotransferase, consistent with the most commonly reported AEs in earlier studies. To balance the efficacy and tolerability of treatment to optimize patient adherence with medications, treating physicians commonly use various strategies such as initiating treatment at a lower dose, dose reduction, or dose interruption, depending on the type and severity of the AEs and the clinical setting. In light of the recent data from first-line treatment, an expert panel of hematologists reviewed management strategies for the use of bosutinib in treatment of CP-CML and made the recommendations reported here. Although the panel focused on first-line treatment, the principles can be for the most part extended to bosutinib use in later lines of treatment. Recommendations include advice regarding prophylaxis and management for diarrhea. The panel also considered optimum timing for referral to a specialist for specific AEs. Across the commonly occurring AEs, the panel highlighted the importance of education and communication with patients about anticipated AEs. FAU - Cortes, Jorge E AU - Cortes JE AUID- ORCID: 0000-0002-8636-1071 AD - University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA. jcortes@mdanderson.org. FAU - Apperley, Jane F AU - Apperley JF AD - Hammersmith Hospital, London, UK. FAU - DeAngelo, Daniel J AU - DeAngelo DJ AD - Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA. FAU - Deininger, Michael W AU - Deininger MW AD - University of Utah Huntsman Cancer Institute, Salt Lake City, UT, USA. FAU - Kota, Vamsi K AU - Kota VK AD - Winship Cancer Institute of Emory University, Atlanta, GA, USA. FAU - Rousselot, Philippe AU - Rousselot P AD - Versailles University, Versailles, France. FAU - Gambacorti-Passerini, Carlo AU - Gambacorti-Passerini C AD - University of Milano-Bicocca, Milan, Italy. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review DEP - 20181227 PL - England TA - J Hematol Oncol JT - Journal of hematology & oncology JID - 101468937 RN - 0 (Aniline Compounds) RN - 0 (Nitriles) RN - 0 (Protein Kinase Inhibitors) RN - 0 (Quinolines) RN - 5018V4AEZ0 (bosutinib) SB - IM MH - Aniline Compounds/*adverse effects/pharmacology MH - Humans MH - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/*drug therapy/pathology MH - Nitriles/*adverse effects/pharmacology MH - Protein Kinase Inhibitors/*adverse effects/pharmacology MH - Quinolines/*adverse effects/pharmacology PMC - PMC6307238 OTO - NOTNLM OT - Adverse events OT - Bosutinib OT - Chronic myeloid leukemia OT - Dosing strategies OT - Tyrosine kinase inhibitor COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Not applicable. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: J.E.C. has received consultancy fees from Pfizer, Novartis, Forma Therapeutics, Daiichi, and Astellas, and research funding from Pfizer, Novartis, Forma Therapeutics, Daiichi, and Astellas. J.F.A. has received honoraria from ARIAD, Bristol-Myers Squibb, Incyte, MSD, Novartis, and Pfizer, and has received research funding from ARIAD, Novartis and Pfizer. D.J.D. has served in a consulting or advisory role for Amgen, ARIAD, Bristol-Myers Squibb, Incyte, Novartis, and Pfizer, and has received research funding from ARIAD. M.W.D. has served in a consulting or advisory role for ARIAD, Bristol-Myers Squibb, Incyte, Novartis, and Pfizer; has received travel, accommodations, or other expense reimbursements from ARIAD, Bristol-Myers Squibb, CTI BioPharma, Novartis, and Pfizer; has provided expert testimony for Bristol-Myers Squibb; has received honoraria from ARIAD, Bristol-Myers Squibb, CTI BioPharma, Incyte, Novartis, and Pfizer; and has received research funding from ARIAD, Bristol-Myers Squibb, Celgene, Incyte, and Novartis. V.K.K. has received consultancy fees from ARIAD, Pfizer, Xcenda, Bristol-Myers Squibb, and Incyte. P.R. reports research funding from Pfizer. C.G.-P. has served in an advisory role to Bristol-Myers Squibb and Pfizer and has received research funding from ARIAD. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/12/28 06:00 MHDA- 2020/01/10 06:00 PMCR- 2018/12/27 CRDT- 2018/12/28 06:00 PHST- 2018/10/23 00:00 [received] PHST- 2018/12/09 00:00 [accepted] PHST- 2018/12/28 06:00 [entrez] PHST- 2018/12/28 06:00 [pubmed] PHST- 2020/01/10 06:00 [medline] PHST- 2018/12/27 00:00 [pmc-release] AID - 10.1186/s13045-018-0685-2 [pii] AID - 685 [pii] AID - 10.1186/s13045-018-0685-2 [doi] PST - epublish SO - J Hematol Oncol. 2018 Dec 27;11(1):143. doi: 10.1186/s13045-018-0685-2.