Bosutinib shows low cross intolerance, in chronic myeloid leukemia patients treated in fourth line. Results of the Spanish compassionate use program

作者：Garcia Gutierrez Valentin; Martinez Trillos Alejandra; Lopez Lorenzo Jose Luis; Bautista Guiomar; Martin Mateos Maria Luisa; Alvarez Larran Alberto; Iglesias Perez Ana; Romo Collado Andres; Fernandez Angeles; Portero Angeles; Cuevas Beatriz; Ruiz Concepcion; Romero Esperanza; Ortega Fernando; Mata Isabel; Tallon Jose; del Carmen Garcia Garay Maria; Ramirez Sanchez Maria Jose; de las Heras Natalia; Giraldo Pilar; Bobillo Sabela; Maria Guinea Jose; Deben Guillermo

来源：American Journal of Hematology, 2015, 90(5): 429-433.

DOI：10.1002/ajh.23973

The role of bosutinib as rescue treatment of Philadelphia chromosome-positive chronic myeloid leukemia (CML) patients after failing three previous tyrosine kinase inhibitors (TKIs) is currently unknown. We report here the largest series (to our knowledge) of patients treated with bosutinib in fourth-line, after retrospectively reviewing 30 patients in chronic phase, and pretreated with imatinib, nilotinib, and dasatinib. With a median follow up of 11.1 months, the probability to either maintain or improve their CCyR response was 56.6% (17/30) and 11 patients (36.7%) achieved or maintained their baseline MMR. In patients not having baseline CCyR, the probabilities of obtaining CCyR, MMR, and MR4.5 were 13, 11, and 14%, respectively. The probabilities of obtaining MMR and deep molecular response MR4.5 in patients with baseline CCyR were 40.0% (6/15) and 20.0% (3/15). At 20 months, progression-free survival was 73%. Grade 3-4 hematological toxicities were more frequent in resistant than intolerant patients (45.4 vs. 0.0%). Nonhematological toxicities were also more frequent in resistant patients, being diarrhea the most conspicuous one. Bosutinib seems to be an appropriate treatment option for patients resistant or intolerant to three prior TKI's.Am. J. Hematol. 90:429-433, 2015.

• 出版日期2015-5