How I individualize frontline treatment for chronic-phase CML

ABSTRACT: Chronic myeloid leukemia (CML) has served as a paradigm for the development of effective initial and next-generation targeted therapies. The availability of 5 effective and generally well-tolerated BCR::ABL1 tyrosine kinase inhibitors for the treatment of newly diagnosed chronic-phase CML offers patients and their treating physicians a welcome luxury of choice. The long-term outlook for patients with newly diagnosed chronic-phase CML is excellent, with expected survival similar to age-matched controls. However, most patients are expected to require lifelong treatment. As a result, important considerations when choosing frontline treatment include not only treatment efficacy but also response durability, tolerability, maximizing quality of life, avoidance of serious and irreversible toxicities, the ease of treatment administration, and, increasingly, the cost of treatment to the patient as well as to society.