What if conventional-dose imatinib fails?
Charles A. Schiffer 1 KARMANOS CANCER INSTITUTE The management of patients with chronic-phase CML refractory to standard doses of imatinib mesylate includes dose escalation, allogeneic transplantation, or a switch to a new BCR/ABL inhibitor. In this issue of Blood, Kantarjian and colleagues present the results of a multicenter trial demonstrating that, for highly refractory patients, treatment with dasatinib is superior to dose escalation of imatinib mesylate. In the short period of time since the initial trials in the late 1990s, imatinib mesylate (Gleevec; Novartis, Basel, Switzerland) has revolutionized the treatment of chronic myelogenous leukemia (CML) and created a model for the development of other so-called targeted therapies. In contrast to the mixed results with putatively targeted treatments in more genetically complex malignancies, imatinib mesylate has been so effective because the single mutation producing the chimeric BCR/ABL protein is sufficient to produce the clinical
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- What if conventional-dose imatinib fails?
