Treatment with a tyrosine kinase inhibitor (TKI) is the standard of care for patients with chronic myeloid leukemia (CML). The new-generation TKIs, nilotinib and dasatinib, are found to have deeper and faster treatment response rates compared to imatinib in the first-line setting. However, a direct comparison between nilotinib and dasatinib has never been reported previously. Our study aims to compare the outcomes and molecular responses achieved following the first-line use of these two agents in patients with CML-CP. The database of the CML Cooperative Study Group was reviewed and patients with CML in the chronic phase (CP) who were given nilotinib or dasatinib as first-line therapy were identified. Out of 361 patients with CML-CP enrolled in our database, 58 and 63 had been treated with conventional doses of nilotinib (300 mg twice daily) and dasatinib (100 mg once daily), respectively, as first-line therapy. The patient demographics did not show significant differences between the groups. The event-free survival rates did not differ between these two groups. The major molecular response (MMR) and the deep molecular response (DMR) rates by 6, 12, 18, and 24 months did not differ between groups. Among the three scoring systems, only the Hasford score could predict the achievement of DMR, and all of them failed to predict the achievement of MMR in the entire cohort. Our data suggest that both nilotinib and dasatinib have comparable efficacies and promising outcomes.
Chronic myeloid leukemia Nilotinib Dasatinib Molecular response Scoring system
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Compliance with ethical standards
Conflict of interest
NI received honoraria and speaker fees from Bristol-Myers Squibb, Novartis Pharma K.K., Otsuka Pharmaceutical, and Pfizer Inc. MT received honoraria and speaker fees from Pfizer Inc. and Bristol-Myers Squibb. MK received honoraria and speaker fees from Bristol-Myers Squibb and Novartis Pharma K.K. TT, and YH received honoraria from Bristol-Myers Squibb and Novartis Pharma K.K. TK received honoraria and speaker fees from Bristol-Myers Squibb, Novartis Pharma K.K., and Pfizer Inc. The remaining authors declare no competing financial interests. All authors have no non-financial conflicts of interest to declare.
All procedures performed in studies were in accordance with the ethical standards of each institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Written informed consent was not required due to retrospective fashion of this study.
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