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Type: Journal article
Title: Phase III, randomized, open-label study of daily Imatinib Mesylate 400 mg versus 800 mg in patients with newly diagnosed, previously untreated chronic myeloid leukemia in chronic phase using molecular end points: Tyrosine Kinase Inhibitor Optimization and Selectivity Study
Author: Cortes, A.
Baccarani, M.
Guilhot, F.
Druker, B.
Branford, S.
Kim, D.
Pane, F.
Pasquini, R.
Goldberg, S.
Kalaycio, M.
Moiraghi, B.
Rowe, J.
Tothova, E.
de Souza, C.
Rudoltz, M.
Yu, R.
Krahnke, T.
Kantarjian, H.
Radich, J.
Hughes, T.
Citation: Journal of Clinical Oncology, 2010; 28(3):424-430
Publisher: Amer Soc Clinical Oncology
Issue Date: 2010
ISSN: 0732-183X
Statement of
Jorge E. Cortes, Michele Baccarani, François Guilhot, Brian J. Druker, Susan Branford, Dong-Wook Kim, Fabrizio Pane, Ricardo Pasquini, Stuart L. Goldberg, Matt Kalaycio, Beatriz Moiraghi, Jacob M. Rowe, Elena Tothova, Carmino De Souza, Marc Rudoltz, Richard Yu, Tillmann Krahnke, Hagop M. Kantarjian, Jerald P. Radich, and Timothy P. Hughes
Abstract: Purpose: To evaluate the safety and efficacy of initial treatment with imatinib mesylate 800 mg/d (400 mg twice daily) versus 400 mg/d in patients with newly diagnosed chronic myeloid leukemia in chronic phase. Patients and Methods: A total of 476 patients were randomly assigned 2:1 to imatinib 800 mg (n = 319) or 400 mg (n = 157) daily. The primary end point was the major molecular response (MMR) rate at 12 months. Results: At 12 months, differences in MMR and complete cytogenetic response (CCyR) rates were not statistically significant (MMR, 46% v 40%; P = .2035; CCyR, 70% v 66%; P = .3470). However, MMR occurred faster among patients randomly assigned to imatinib 800 mg/d, who had higher rates of MMR at 3 and 6 months compared with those in the imatinib 400-mg/d arm (P = .0035 by log-rank test). CCyR also occurred faster in the 800-mg/d arm (CCyR at 6 months, 57% v 45%; P = .0146). The most common adverse events were edema, gastrointestinal problems, and rash, and all were more common in patients in the 800-mg/d arm. Grades 3 to 4 hematologic toxicity also occurred more frequently in patients receiving imatinib 800 mg/d. Conclusion: MMR rates at 1 year were similar with imatinib 800 mg/d and 400 mg/d, but MMR and CCyR occurred earlier in patients treated with 800 mg/d. Continued follow-up is needed to determine the clinical significance of earlier responses on high-dose imatinib.
Keywords: Humans; Leukemia, Myeloid, Chronic-Phase; Benzamides; Piperazines; Pyrimidines; Antineoplastic Agents; Protein Kinase Inhibitors; Treatment Outcome; Dose-Response Relationship, Drug; Adolescent; Adult; Aged; Middle Aged; Female; Male; Protein-Tyrosine Kinases; Young Adult; Imatinib Mesylate
Rights: © 2009 by American Society of Clinical Oncology
RMID: 0020100132
DOI: 10.1200/JCO.2009.25.3724
Appears in Collections:Medicine publications

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