Burden of Tyrosine Kinase Inhibitor Failure in Patients with Chronic Myeloid Leukemia

Tyrosine kinase inhibitors (TKIs) have been extremely effective at inducing remissions and slowing down the progression of chronic myeloid leukemia (CML) resulting in a significant reduction in morbidity and mortality. Most patients with CML must remain on TKIs indefinitely and many experience resistance or intolerance to TKIs requiring a switch to a second-line TKI, third-line TKI or more. The purpose of the current review is to examine the underlying factors and subsequent economic and quality of life burdens associated with TKI failure. We discuss the definitions and rates of TKI failure in CML and the extent to which mutations and non-adherence are associated with TKI failure. We also review the few studies that have examined economic and patient outcomes associated with TKI failure and we suggest avenues for future research examining the consequences of TKI failure.