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Nilotinib

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Small Molecules in Hematology

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 212))

Abstract

With imatinib still being linked to the breakthrough in CML therapy and probably being the most prescribed drug, second-generation TKIs are increasingly gaining importance. Showing higher response rates while not leading to more adverse events, nilotinib has become an attractive option in the first-line treatment of chronic-phase chronic myeloid leukemia. By reaching deep and long-lasting molecular remissions, discontinuation of TKIs is becoming one of the central topics of future CML therapy. Stopping nilotinib seems safe and provides a stable remission in about half of the eligible patients, though long-term data are still missing.

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References

  • Aichberger KJ, Herndlhofer S, Schernthaner G-H et al (2011) Progressive peripheral arterial occlusive disease and other vascular events during nilotinib therapy in CML. Am J Hematol 86:533–539

    Article  CAS  PubMed  Google Scholar 

  • Apperley JF (2007) Part I: mechanisms of resistance to imatinib in chronic myeloid leukaemia. Lancet Oncol 8:1018–1029

    Article  CAS  PubMed  Google Scholar 

  • Baccarani M, Cortes J, Pane F (2009) Chronic myeloid leukemia: an update of concepts and management recommendations of European LeukemiaNet. J Clin Oncol 27:6041–6051

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Baccarani M, Deininger MW, Rosti G et al (2013) European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013. Blood 122:872–894

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bradeen HA, Eide CA, O’Hare T et al (2006) Comparison of imatinib mesylate, dasatinib (BMS-354825), and nilotinib (AMN107) in an N-ethyl-N-nitrosourea (ENU)-based mutagenesis screen: high efficacy of drug combinations. Blood 108:2332–2338

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Cortes JE, De Souza CA, Ayala M et al (2016) Switching to nilotinib versus imatinib dose escalation in patients with chronic myeloid leukaemia in chronic phase with suboptimal response to imatinib (LASOR): a randomised, open-label trial. Lancet Haematol 3:e581–e591

    Article  PubMed  Google Scholar 

  • Druker BJ, Tamura S, Buchdunger E, Ohno S (1996) Effects of a selective inhibitor of the Abl tyrosine kinase on the growth of Bcr-Abl positive cells. Nat Med 2:561–566

    Article  CAS  PubMed  Google Scholar 

  • Druker BJ, Guilhot F, O’Brien S et al (2006) Long-term benefits of imatinib (IM) for patients newly diagnosed with chronic myelogenous leukemia in chronic phase (CML-CP): the 5-year update from the IRIS study. J Clin Oncol 24:338S–338S

    Google Scholar 

  • Ernst T, La Rosee P, Mueller MC, Hochhaus A (2011) Bcr-Abl mutations in chronic myeloid leukemia. Hematol Oncol Clin North Am 25:997–1008

    Article  PubMed  Google Scholar 

  • Giles FJ, Larson RA, Kantarjian HM (2008) Nilotinib in patients with Philadelphia chromosome-positive chronic myelogenous leukemia in blast crisis (CML-BC) who are resistant or intolerant to imatinib—Giles et al. 26 (15 supplement): 7017—ASCO meeting abstracts. J Clin Oncol 26:7017

    Google Scholar 

  • Giles FJ, Abruzzese E, Rosti G et al (2010) Nilotinib is active in chronic and accelerated phase chronic myeloid leukemia following failure of imatinib and dasatinib therapy. Leukemia 24:1299–1301

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Giles FJ, Kantarjian HM, le Coutre PD et al (2012) Nilotinib is effective in imatinib-resistant or -intolerant patients with chronic myeloid leukemia in blastic phase. Leukemia 26:959–962

    Article  CAS  PubMed  Google Scholar 

  • Giles FJ, le Coutre PD, Pinilla-Ibarz J et al (2013) Nilotinib in imatinib-resistant or imatinib-intolerant patients with chronic myeloid leukemia in chronic phase: 48-month follow-up results of a phase II study. Leukemia 27:107–112

    Article  CAS  PubMed  Google Scholar 

  • Giles FJ, Rea D, Rosti G et al (2017) Impact of age on efficacy and toxicity of nilotinib in patients with chronic myeloid leukemia in chronic phase: ENEST1st subanalysis. J Cancer Res Clin Oncol 143:1585–1596

    Google Scholar 

  • Golemovic M, Verstovsek S, Giles F et al (2005) AMN107, a novel aminopyrimidine inhibitor of Bcr-Abl, has in vitro activity against imatinib-resistant chronic myeloid leukemia. Clin Cancer Res 11:4941–4947

    Article  CAS  PubMed  Google Scholar 

  • Gorre ME, Mohammed M, Ellwood K et al (2001) Clinical resistance to STI-571 cancer therapy caused by Bcr-Abl gene mutation or amplification. Science 293:876–880

    Article  CAS  PubMed  Google Scholar 

  • Haouala A, Widmer N, Duchosal MA et al (2011) Drug interactions with the tyrosine kinase inhibitors imatinib, dasatinib, and nilotinib. Blood 117:E75–E87

    Article  CAS  PubMed  Google Scholar 

  • Hochhaus A, Saglio G, Larson RA et al (2013) Nilotinib is associated with a reduced incidence of Bcr-Abl mutations vs imatinib in patients with newly diagnosed chronic myeloid leukemia in chronic phase. Blood 121:3703–3708

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hochhaus A, Saglio G, Hughes TP et al (2016a) Long-term benefits and risks of frontline nilotinib vs imatinib for chronic myeloid leukemia in chronic phase: 5-year update of the randomized ENESTnd trial. Leukemia 30:1044–1054

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hochhaus A, Rosti G, Cross NCP et al (2016b) Frontline nilotinib in patients with chronic myeloid leukemia in chronic phase: results from the European ENEST1st study. Leukemia 30:57–64

    Article  CAS  PubMed  Google Scholar 

  • Hochhaus A, Masszi T, Giles FJ et al (2017) Treatment-free remission following frontline nilotinib in patients with chronic myeloid leukemia in chronic phase: results from the ENESTfreedom study. Leukemia 31:1525–1531

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hughes P, Hochhaus A, Kantarjian H et al (2014a) Safety and efficacy of switching to nilotinib 400 mg twice daily for patients with chronic myeloid leukemia in chronic phase with suboptimal response or failure on front-line imatinib or nilotinib 300 mg twice daily. Hematologica 99(7):1204–1211

    Article  CAS  Google Scholar 

  • Hughes TP, Saglio G, Kantarjian H et al (2014b) Early molecular response predicts outcomes in patients with chronic myeloid leukemia in chronic phase treated with frontline nilotinib or imatinib. Blood 123:1353–1360

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hughes TP, Boquimpani C, Takahashi N et al (2016) Results from ENESTop: Treatment-free remission (TFR) following switch to nilotinib in patients with chronic myeloid leukemia in chronic phase. ASCO 2016 abstract #7054

    Google Scholar 

  • Jain P, Kantarjian H, Nazha A et al (2013) Early responses predicts for better outcomes in patients with newly diagnosed CML: results with four TKI modalities. Blood 121:4867–4874

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kagan M, Tran P, Fischer V et al (2005) Safety, pharmacokinetics (PK), metabolism, and mass balance of [C-14]-AMN107, a novel aminopyrimidine inhibitor of Bcr-Abl tyrosine kinase, in healthy subjects. Blood 106:302B–302B

    Google Scholar 

  • Kantarjian H, Giles F, Wunderle L et al (2006) Nilotinib in imatinib-resistant CML and Philadelphia chromosome-positive ALL. N Engl J Med 354:2542–2551

    Article  PubMed  Google Scholar 

  • Kantarjian HM, Giles F, Gattermann N et al (2007) Nilotinib (formerly AMN107), a highly selective Bcr-Abl tyrosine kinase inhibitor, is effective in patients with Philadelphia chromosome-positive chronic myelogenous leukemia in chronic phase following imatinib resistance and intolerance. Blood 110:3540–3546

    Article  CAS  PubMed  Google Scholar 

  • Kantarjian HM, Giles FJ, Bhalla KN et al (2011a) Nilotinib is effective in patients with chronic myeloid leukemia in chronic phase after imatinib resistance or intolerance: 24-month follow-up results. Blood 117:1141–1145

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kantarjian HM, Hochhaus A, Saglio G et al (2011b) Nilotinib versus imatinib for the treatment of patients with newly diagnosed chronic phase, Philadelphia chromosome-positive, chronic myeloid leukaemia: 24-month minimum follow-up of the phase 3 randomised ENESTnd trial. Lancet Oncol 12:841–851

    Article  CAS  PubMed  Google Scholar 

  • Kim TD, Schwarz M, Nogai H et al (2010) Thyroid dysfunction caused by second-generation tyrosine kinase inhibitors in Philadelphia chromosome-positive chronic myeloid leukemia. Thyroid 20(11):1209–1214

    Article  CAS  PubMed  Google Scholar 

  • Kim TD, Rea D, Schwarz M et al (2013) Peripheral artery occlusive disease in chronic phase chronic myeloid leukemia patients treated with nilotinib or imatinib. Leukemia 27:1316–1321

    Article  CAS  PubMed  Google Scholar 

  • Larson RA, Hochhaus A, Hughes TP et al (2012) Nilotinib vs imatinib in patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase: ENESTnd 3-year follow-up. Leukemia 26:2197–2203

    Article  CAS  PubMed  Google Scholar 

  • Larson RA, Hochhaus A, Saglio G et al (2013) Nilotinib vs imatinib in patients with newly diagnosed chronic myeloid leukemia in chronic phase (CML-CP): ENESTnd 4-year update. J Clin Oncol (suppl) 31:abstr. 7052

    Google Scholar 

  • le Coutre P, Ottmann OG, Giles F et al (2008) Nilotinib (formerly AMN107), a highly selective Bcr-Abl tyrosine kinase inhibitor, is active in patients with imatinib-resistant or -intolerant accelerated-phase chronic myelogenous leukemia. Blood 111:1834–1839

    Article  CAS  PubMed  Google Scholar 

  • le Coutre P, Rea D, Abruzzese E et al (2011) Severe peripheral arterial disease during nilotinib therapy. J Natl Cancer Inst 103:1347–1348

    Article  CAS  PubMed  Google Scholar 

  • le Coutre PD, Giles FJ, Hochhaus A et al (2012) Nilotinib in patients with Ph+ chronic myeloid leukemia in accelerated phase following imatinib resistance or intolerance: 24-month follow-up results. Leukemia 26:1189–1194

    Article  CAS  PubMed  Google Scholar 

  • Mahon F-X, Rea D, Guilhot J et al (2010) Discontinuation of imatinib in patients with chronic myeloid leukaemia who have maintained complete molecular remission for at least 2 years: the prospective, multicentre stop imatinib (STIM) trial. Lancet Oncol 11:1029–1035

    Article  CAS  PubMed  Google Scholar 

  • Mahon FX, Richter J, Guilhot J et al (2016) Cessation of tyrosine kinase inhibitors treatment in chronic myeloid leukemia patients with deep molecular response: results of the euro-ski trial. Blood 128:787

    Google Scholar 

  • Manley PW, Breitenstein W, Brüggen J et al (2004) Urea derivatives of STI571 as inhibitors of Bcr-Abl and PDCFR kinases. Bioorg Med Chem Lett 14:5793–5797

    Article  CAS  PubMed  Google Scholar 

  • Mori S, Vagge E, le Coutre P et al (2015) Age and dPCR can predict relapse in CML patients who discontinued imatinib: the ISAV study. Am J Hematol 90(10):910–914

    Article  CAS  PubMed  Google Scholar 

  • Nowell PC, Hungerford DA (1960) A minute chromosome in human chronic granulocytic leukemia. Science 142:1497

    Google Scholar 

  • O’Hare T, Walters DK, Stoffregen EP et al (2005) In vitro activity of Bcr-Abl inhibitors AMN107 and BMS-354825 against clinically relevant imatinib-resistant Abl kinase domain mutants. Cancer Res 65:4500–4505

    Article  PubMed  Google Scholar 

  • O’Hare T, Eide CA, Deininger MWN (2007) Bcr-Abl kinase domain mutations, drug resistance, and the road to a cure for chronic myeloid leukemia. Blood 110:2242–2249

    Article  CAS  PubMed  Google Scholar 

  • Quintás-Cardama A, Kantarjian H, Cortes J (2012) Nilotinib-associated vascular events. Clin Lymphoma Myeloma Leuk 12:337–340

    Article  CAS  PubMed  Google Scholar 

  • Radich JP, Deininger M, Abboud CN et al (2017) NCCN guidelines version 1.2018 chronic myeloid leuemia. NCCN, Professionals, Physician Guidelines, Chronic Myeloid Leukemia. Accessed on Sept 10 2017

    Google Scholar 

  • Ray A, Cowan-Jacob SW, Manley PW et al (2007) Identification of Bcr-Abl point mutations conferring resistance to the Abl kinase inhibitor AMN107 (nilotinib) by a random mutagenesis study. Blood 109:5011–5015

    Article  CAS  PubMed  Google Scholar 

  • Rea D, Rosti G, Cross N et al (2015) Enestpath: a phase III study to assess the effect of nilotinib treatment duration on treatment-free remission (TFR) in chronic phase-chronic myeloid leukemia (CP-CML) patients (pts) previously treated with imatinib: interim analysis from the first year of induction phase. Blood 126:4040

    Google Scholar 

  • Rea D, Nicolini FE, Tulliez M et al (2016) Discontinuation of dasatinib or nilotinib in chronic myeloid leukemia: interim analysis of the STOP 2G-TKI study. Blood 129:846–854

    Article  CAS  PubMed  Google Scholar 

  • Redaelli S, Mologni L, Rostagno R et al (2012) Three novel patient-derived BCR/ABL mutants show different sensitivity to second and third generation tyrosine kinase inhibitors. Am J Hematol 87:E125–E128

    Article  CAS  PubMed  Google Scholar 

  • Rix U, Hantschel O, Duernberger G et al (2007) Chemical proteomic profiles of the Bcr-Abl inhibitors imatinib, nilotinib, and dasatinib, reveal novel kinase and nonkinase targets. Blood 110:4055–4063

    Article  CAS  PubMed  Google Scholar 

  • Rowley JD (1973) A new consistent chromosomal abnormality in chronic myelogenous leukaemia identified by quinacrine fluorescence and Giemsa staining. Nature 243(5405):290–293

    Article  CAS  PubMed  Google Scholar 

  • Saglio G, Kim D-W, Issaragrisil S et al (2010) Nilotinib versus imatinib for newly diagnosed chronic myeloid leukemia. N Engl J Med 362:2251–2259

    Article  CAS  PubMed  Google Scholar 

  • Shah NP, Nicoll JM, Nagar B et al (2002) Multiple Bcr-Abl kinase domain mutations confer polyclonal resistance to the tyrosine kinase inhibitor imatinib (STI571) in chronic phase and blast crisis chronic myeloid leukemia. Cancer Cell 2:117–125

    Article  CAS  PubMed  Google Scholar 

  • Soverini S, Colarossi S, Gnani A et al (2006) Contribution of ABL kinase domain mutations to imatinib resistance in different subsets of Philadelphia-positive patients: by the GIMEMA working party on chronic myeloid leukemia. Clin Cancer Res 12(24):7374–7379

    Article  CAS  PubMed  Google Scholar 

  • Steegmann JL, Baccarani M, Breccia M et al (2016) European leukemia net recommendations for the management and avoidance of adverse events of treatment in chronic myeloid leukaemia. Leukemia 30:1648–1671

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tanaka C, Yin OQP, Sethuraman V et al (2009) Clinical pharmacokinetics of the Bcr-Abl tyrosine kinase inhibitor nilotinib. Clin Pharmacol Ther 87:197–203

    Article  CAS  PubMed  Google Scholar 

  • Tanaka C, Yin OQP, Smith T et al (2011) Effects of rifampin and ketoconazole on the pharmacokinetics of nilotinib in healthy participants. J Clin Pharmacol 51:75–83

    Article  CAS  PubMed  Google Scholar 

  • von Bubnoff N, Manley PW, Mestan J et al (2006) Bcr-Abl resistance screening predicts a limited spectrum of point mutations to be associated with clinical resistance to the Abl kinase inhibitor nilotinib (AMN107). Blood 108:1328–1333

    Article  CAS  Google Scholar 

  • Weisberg E, Manley PW, Breitenstein W et al (2005) Characterization of AMN107, a selective inhibitor of native and mutant Bcr-Abl. Cancer Cell 7:129–141

    Article  CAS  PubMed  Google Scholar 

  • Weisberg E, Manley P, Mestan J et al (2006) AMN107 (nilotinib): a novel and selective inhibitor of Bcr-Abl. Br J Cancer 94:1765–1769

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Yin OQP, Gallagher N, Li A et al (2010) Effect of grapefruit juice on the pharmacokinetics of nilotinib in healthy participants. J Clin Pharmacol 50:188–194

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Martin Gresse .

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Gresse, M., Kim, T.D., le Coutre, P. (2018). Nilotinib. In: Martens, U. (eds) Small Molecules in Hematology. Recent Results in Cancer Research, vol 212. Springer, Cham. https://doi.org/10.1007/978-3-319-91439-8_3

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  • DOI: https://doi.org/10.1007/978-3-319-91439-8_3

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