Bosutinib in chronic myeloid leukemia: patient selection and perspectives

Figures & data

Figure 1 Study 200: Patient cohorts (n=570) in second+ line.

Notes: Data from Cortes et al.^{15 #}indicates bosutinib is not indicated for Ph+ ALL; *indicates primary efficacy endpoint of the study was the MCyR rate at week 24 in patients with imatinib-resistant CP CML previously treated with only one prior TKI (imatinib); **indicates three chronic phase CML patients in fourth-line, and one nilotinib intolerant patient in third-line treatment.
Abbreviations: ALL, acute lymphocytic leukemia; AP, accelerated phase; BP, blastic phase; CML, chronic myeloid leukemia; CP, chronic phase; MCyR, major cytogenetic response.

Table 1 Most frequent side effects of all approved TKI

	Imatinib	Nilotinib	Dasatinib	Bosutinib	Ponatinib
Hematologic	Neutropenia		Neutropenia, thrombocytopenia
Lab values	Phosphate	Lipase, ALT, AST, blood glucose	Changes in coagulation parameters	ALT, AST, Lipase	Lipase, blood glucose, cholesterol, triglyceride
Non-lab AEs	Muscle cramps, edema	Rash, PAOD, other vascular events	Pleural effusion, Pulmonal hypertension	Nausea, vomiting, diarrhea	Rash, PAOD, arterial and venous events, arterial hypertension

Abbreviation: AEs, adverse events; ALT, alanine transaminase; AST, aspartate transaminase; PAOD, peripheral arterial vascular occlusive disease; TKI, tyrosine kinase inhibitors.

Table 2 Efficacy parameters of bosutinib, nilotinib and dasatinib in first- and second-line treatment

	Bosutinib	Nilotinib	Dasatinib
MMR rate after 24 months of first-line therapy	59^Citation19	71^Citation38	64^Citation39
CCyR rate of second line treatment after imatinib failure/intolerance	48^Citation9	41^Citation40	44^Citation41

Abbreviations: CCyR, complete cytogenetic response; MMR, major molecular response.

Figure 2 Recommendations for TKI treatment with regard to comorbidity status.

Note: Adapted with permission from Wolf D, Brümmendorf TH, Isfort S. Individualisierte Therapie der CML: Bedeutung patienten- und krankheitsspezifischer Parameter für eine optimale Therapiewahl. [Individualized therapy for CML: importance of patient- and illness- specific parameters in order to choose the optimal therapy]. Thieme Praxis Report. 2015;7:9.⁴²

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