Literature Scan
Bosutinib BFORE Imatinib : Evaluating Frontline Treatment for Patients With Newly Diagnosed CML
Results from the phase III BFORE trial suggest that treatment with the secondgeneration tyrosine kinase inhibitor bosutinib is associated with higher rates of cytogenetic and molecular responses than imatinib in patients with newly diagnosed chronic-phase chronic myeloid leukemia ( CP-CML ), according to a report published in the Journal of Clinical Oncology . Jorge E . Cortes , MD , from the MD Anderson Cancer Center at the University of Texas in Houston , and co-authors also reported that responses occurred earlier than in imatinib-treated patients .
In the multicenter , open-label trial , the researchers randomized 536 adult patients with CP-CML 1:1 to receive bosutinib 400 mg once-daily or imatinib 400 mg once-daily ( n = 268 in each arm ). Patients were excluded from the trial if they received prior CML treatment , had central nervous system involvement , or had a history of significant cardiac disease .
In the present study , the authors presented results from a modified intent-to-treat population of 246 bosutinib-treated patients ( median age = 52 years ; range = 18-84 years ) and 241 imatinib-treated patients ( median age = 53 years ; range = 19-84 years ) with Philadelphia chromosome-positive patients with typical BCR-ABL1 transcript types ( e13a2 and / or e14a2 ).
Patients were treated with a median dose intensity of 392 mg once-daily ( range = 39-557 mg ) in the bosutinib group and
400 mg once-daily ( range = 189-679 mg ) in the imatinib group . Median duration on study treatment was 15.6 and 15.3 months ( ranges not provided ), respectively .
At 12 months of follow-up , 219 ( 81.7 %) bosutinib-treated patients and 218 ( 82.3 %) imatinib-treated patients were still receiving treatment . Treatment discontinuations were most often related to adverse events ( AEs ), and discontinuation due to AEs appeared
“ These results suggest that bosutinib can be an important alternative for ... previously untreated chronicphase chronic myeloid leukemia .”
80 ASH Clinical News
— JORGE E . CORTES , MD
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