Dasatinib may be an appropriate treatment for imatinib-intolerant patients with chronic myeloid leukemia (CML), according to a study of cross-intolerance between imatinib and dasatinib in 271 patients with CML and imatinib intolerance. Researchers found:

• Overall, 17% of patients had cross-intolerance to dasatinib based on recurrence of grade 3–4 AEs.

• Among 228 patients who discontinued imatinib due to nonhematologic intolerance, 10 experienced the same severe nonhematologic AEs with dasatinib, with 4 discontinuing dasatinib due to cross-intolerance.

• Of 43 patients who discontinued imatinib because of hematologic intolerance, 37 had recurrence of grade 3–4 hematologic AEs with dasatinib, with 8 discontinuing dasatinib due to cross-intolerance.

• Of 43 patients taking dasatinib at the optimized dose, 1 discontinued therapy due to recurrence of nonhematologic AEs, and 3 discontinued due to recurrence of hematologic AEs.

• After a median treatment duration of 22 months, estimated rates of PFS (94% vs 68%) and OS (98% vs 88%) at 2 years were higher in patients with nonhematologic vs hematologic intolerance to imatinib who switched to dasatinib.

Citation: Khoury HJ, Goldberg SL, Mauro MJ, et al. Cross-intolerance with dasatinib among imatinib-intolerant patients with chronic-phase chronic myeloid leukemia. [Published online ahead of print March 29, 2016]. Clin Lymphoma Myeloma Leuk. doi:10.1016/j.clml.2016.03.004.