作者
Xiaoshuai Zhang,Na Xu,Yunfan Yang,Hai Lin,Bingcheng Liu,Xin Du,Xiaoli Liu,Rong Liang,Chunyan Chen,Jing Huang,Huanling Zhu,Ling Pan,Xiaodong Wang,Guohui Li,Zhuogang Liu,Yanqing Zhang,Zhenfang Liu,Jianda Hu,Chunshui Liu,Li Fei,Wei Yang,Meng Li,Yanqiu Han,Lie Lin,Zhenyu Zhao,Chuanqing Tu,Chunhua Zheng,Yanliang Bai,Zeping Zhou,Suning Chen,Huiying Qiu,Yang Liu,Xuping Sun,Hui Sun,Li Zhou,Zelin Liu,Danyu Wang,Jianxin Guo,Liping Pang,Qingshu Zeng,Xiaohui Suo,Weihua Zhang,Yaguang Zheng,Yanli Zhang,Weiming Li,Qian Jiang
摘要
Abstract
Background
There are limited data comprehensively comparing therapy responses and outcomes among nilotinib, dasatinib, flumatinib and imatinib for newly diagnosed chronic-phase chronic myeloid leukemia in a real-world setting. Patients and Methods
Data from patients with chronic-phase CML receiving initial a second-generation tyrosine-kinase inhibitor (2G-TKI, nilotinib, dasatinib or flumatinib) or imatinib therapy from 77 Chinese centers were retrospectively interrogated. Propensity-score matching (PSM) analyses were performed to to compare therapy responses and outcomes among these 4 TKIs. Results
2,496 patients receiving initial nilotinib (n = 512), dasatinib (n = 134), flumatinib (n = 411) or imatinib (n = 1,439) therapy were retrospectively interrogated in this study. PSM analyses indicated that patients receiving initial nilotinib, dasatinib or flumatinib therapy had comparable cytogenetic and molecular responses (p = 0.28 - 0.91) and survival outcomes including failure-free survival (FFS, p = 0.28 - 0.43), progression-free survival (PFS, p = 0.19 - 0.93) and overall survival (OS) (p values = 0.76 - 0.78) but had significantly higher cumulative incidences of cytogenetic and molecular responses (all p values < 0.001) and higher probabilities of FFS (p < 0.001 - 0.01) than those receiving imatinib therapy, despite comparable PFS (p = 0.18 - 0.89) and OS (p = 0.23 - 0.30). Conclusion
Nilotinib, dasatinib and flumatinib had comparable efficacy, and significantly higher therapy responses and higher FFS rates than imatinib in newly diagnosed CML patients. However, there were no significant differences in PFS and OS among these 4 TKIs. These real-world data may provide additional evidence for routine clinical assessments to identify more appropriate therapies.