Phase II Study of Dasatinib in Philadelphia Chromosome–Negative Acute and Chronic Myeloid Diseases, Including Systemic Mastocytosis
Purpose: Molecular characterization of Philadelphia chromosome–negative (Ph−) chronic myeloproliferative disorders, such as systemic mastocytosis (SM), has provided a clear rationale for investigating novel targeted therapies. The tyrosine kinase (TK) inhibitor dasatinib is 325-fold more potent agai...
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Published in | Clinical cancer research Vol. 14; no. 12; pp. 3906 - 3915 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Philadelphia, PA
American Association for Cancer Research
15.06.2008
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Abstract | Purpose: Molecular characterization of Philadelphia chromosome–negative (Ph−) chronic myeloproliferative disorders, such as systemic
mastocytosis (SM), has provided a clear rationale for investigating novel targeted therapies. The tyrosine kinase (TK) inhibitor
dasatinib is 325-fold more potent against Bcr-Abl TK than imatinib in vitro , significantly inhibiting wild-type KIT and platelet-derived growth factor receptor β TKs, and is active against cells carrying
the mutant KIT-D816V gene.
Experimental Design: In this phase 2, open-label study, the efficacy of dasatinib (140 mg/d) was investigated in 67 patients with various Ph−
myeloid disorders, including SM ( n = 33; 28 KIT-D816V positive).
Results: The overall response rate to dasatinib in patients with SM was 33%. Only two patients, one with SM-myelofibrosis and one
with SM-chronic eosinophilic leukemia, achieved complete response (elimination of mastocytosis) lasting for 5 and 16 months,
respectively. Both patients were negative for KIT-D816V mutation, had low tryptase levels, abnormal WBC counts, and anemia,
and had failed prior therapy with erythropoietin. Additional nine SM patients had symptomatic response, lasting 3 to 18+ months.
Complete responses were achieved in two other patients (acute myeloid leukemia and hypereosinophilic syndrome). No responses
were observed among patients with myelodysplastic syndromes and primary myelofibrosis. The majority of adverse events were
grade 1/2.
Conclusion: These data show that dasatinib therapy may benefit a selected group of SM patients, primarily by improving their symptoms,
but it does not eliminate the disease in the patients with KIT-D816V mutation. |
---|---|
AbstractList | Molecular characterization of Philadelphia chromosome-negative (Ph−) chronic myeloproliferative disorders, such as systemic mastocytosis (SM), has provided a clear rationale for investigating novel targeted therapies. The tyrosine kinase (TK) inhibitor dasatinib is 325-fold more potent against Bcr-Abl TK than imatinib
in vitro
, significantly inhibiting wild-type KIT and PDGFR-B TKs, and is active against cells carrying the mutant KIT-D816V gene. In this phase 2, open-label study, the efficacy of dasatinib (140 mg/day) was investigated in 67 patients with various Ph− myeloid disorders, including SM (N=33; 28 KIT-D816V positive).
The overall response rate to dasatinib in patients with SM was 33%. Only two patients, one with SM-myelofibrosis and one with SM-chronic eosinophilic leukemia, achieved complete response (elimination of mastocytosis) lasting for 5 and 16 months, respectively. Both patients were negative for KIT-D816V mutation, had low tryptase levels, abnormal WBC counts, and anemia, and had failed prior therapy with erythropoietin. Additional 9 SM patients had symptomatic response, lasting 3 to 18+ months.
Complete responses were achieved in two other patients (acute myeloid leukemia, hypereosinophilic syndrome). No responses were observed among patients with myelodysplastic syndromes and primary myelofibrosis. The majority of adverse events were grade 1/2. These data show that dasatinib may benefit a selected group of SM patients, primarily by improving their symptoms. Purpose: Molecular characterization of Philadelphia chromosome–negative (Ph−) chronic myeloproliferative disorders, such as systemic mastocytosis (SM), has provided a clear rationale for investigating novel targeted therapies. The tyrosine kinase (TK) inhibitor dasatinib is 325-fold more potent against Bcr-Abl TK than imatinib in vitro , significantly inhibiting wild-type KIT and platelet-derived growth factor receptor β TKs, and is active against cells carrying the mutant KIT-D816V gene. Experimental Design: In this phase 2, open-label study, the efficacy of dasatinib (140 mg/d) was investigated in 67 patients with various Ph− myeloid disorders, including SM ( n = 33; 28 KIT-D816V positive). Results: The overall response rate to dasatinib in patients with SM was 33%. Only two patients, one with SM-myelofibrosis and one with SM-chronic eosinophilic leukemia, achieved complete response (elimination of mastocytosis) lasting for 5 and 16 months, respectively. Both patients were negative for KIT-D816V mutation, had low tryptase levels, abnormal WBC counts, and anemia, and had failed prior therapy with erythropoietin. Additional nine SM patients had symptomatic response, lasting 3 to 18+ months. Complete responses were achieved in two other patients (acute myeloid leukemia and hypereosinophilic syndrome). No responses were observed among patients with myelodysplastic syndromes and primary myelofibrosis. The majority of adverse events were grade 1/2. Conclusion: These data show that dasatinib therapy may benefit a selected group of SM patients, primarily by improving their symptoms, but it does not eliminate the disease in the patients with KIT-D816V mutation. Abstract Purpose: Molecular characterization of Philadelphia chromosome–negative (Ph−) chronic myeloproliferative disorders, such as systemic mastocytosis (SM), has provided a clear rationale for investigating novel targeted therapies. The tyrosine kinase (TK) inhibitor dasatinib is 325-fold more potent against Bcr-Abl TK than imatinib in vitro, significantly inhibiting wild-type KIT and platelet-derived growth factor receptor β TKs, and is active against cells carrying the mutant KIT-D816V gene. Experimental Design: In this phase 2, open-label study, the efficacy of dasatinib (140 mg/d) was investigated in 67 patients with various Ph− myeloid disorders, including SM (n = 33; 28 KIT-D816V positive). Results: The overall response rate to dasatinib in patients with SM was 33%. Only two patients, one with SM-myelofibrosis and one with SM-chronic eosinophilic leukemia, achieved complete response (elimination of mastocytosis) lasting for 5 and 16 months, respectively. Both patients were negative for KIT-D816V mutation, had low tryptase levels, abnormal WBC counts, and anemia, and had failed prior therapy with erythropoietin. Additional nine SM patients had symptomatic response, lasting 3 to 18+ months. Complete responses were achieved in two other patients (acute myeloid leukemia and hypereosinophilic syndrome). No responses were observed among patients with myelodysplastic syndromes and primary myelofibrosis. The majority of adverse events were grade 1/2. Conclusion: These data show that dasatinib therapy may benefit a selected group of SM patients, primarily by improving their symptoms, but it does not eliminate the disease in the patients with KIT-D816V mutation. PURPOSE: Molecular characterization of Philadelphia chromosome-negative (Ph-) chronic myeloproliferative disorders, such as systemic mastocytosis (SM), has provided a clear rationale for investigating novel targeted therapies. The tyrosine kinase (TK) inhibitor dasatinib is 325-fold more potent against Bcr-Abl TK than imatinib in vitro, significantly inhibiting wild-type KIT and platelet-derived growth factor receptor beta TKs, and is active against cells carrying the mutant KIT-D816V gene. Experimental Design: In this phase 2, open-label study, the efficacy of dasatinib (140 mg/d) was investigated in 67 patients with various Ph- myeloid disorders, including SM (n = 33; 28 KIT-D816V positive). RESULTS: The overall response rate to dasatinib in patients with SM was 33%. Only two patients, one with SM-myelofibrosis and one with SM-chronic eosinophilic leukemia, achieved complete response (elimination of mastocytosis) lasting for 5 and 16 months, respectively. Both patients were negative for KIT-D816V mutation, had low tryptase levels, abnormal WBC counts, and anemia, and had failed prior therapy with erythropoietin. Additional nine SM patients had symptomatic response, lasting 3 to 18+ months. Complete responses were achieved in two other patients (acute myeloid leukemia and hypereosinophilic syndrome). No responses were observed among patients with myelodysplastic syndromes and primary myelofibrosis. The majority of adverse events were grade 1/2. CONCLUSION: These data show that dasatinib therapy may benefit a selected group of SM patients, primarily by improving their symptoms, but it does not eliminate the disease in the patients with KIT-D816V mutation. Molecular characterization of Philadelphia chromosome-negative (Ph-) chronic myeloproliferative disorders, such as systemic mastocytosis (SM), has provided a clear rationale for investigating novel targeted therapies. The tyrosine kinase (TK) inhibitor dasatinib is 325-fold more potent against Bcr-Abl TK than imatinib in vitro, significantly inhibiting wild-type KIT and platelet-derived growth factor receptor beta TKs, and is active against cells carrying the mutant KIT-D816V gene. In this phase 2, open-label study, the efficacy of dasatinib (140 mg/d) was investigated in 67 patients with various Ph- myeloid disorders, including SM (n = 33; 28 KIT-D816V positive). The overall response rate to dasatinib in patients with SM was 33%. Only two patients, one with SM-myelofibrosis and one with SM-chronic eosinophilic leukemia, achieved complete response (elimination of mastocytosis) lasting for 5 and 16 months, respectively. Both patients were negative for KIT-D816V mutation, had low tryptase levels, abnormal WBC counts, and anemia, and had failed prior therapy with erythropoietin. Additional nine SM patients had symptomatic response, lasting 3 to 18+ months. Complete responses were achieved in two other patients (acute myeloid leukemia and hypereosinophilic syndrome). No responses were observed among patients with myelodysplastic syndromes and primary myelofibrosis. The majority of adverse events were grade 1/2. These data show that dasatinib therapy may benefit a selected group of SM patients, primarily by improving their symptoms, but it does not eliminate the disease in the patients with KIT-D816V mutation. |
Author | Stefan Faderl Susan O'Brien Taghi Manshouri Cem Akin Hagop Kantarjian Guillermo Garcia-Manero Jorge Cortes Deborah Thomas Ayalew Tefferi Srdan Verstovsek Animesh Pardanani |
AuthorAffiliation | 1 Leukemia Department, MD Anderson Cancer Center, Houston, TX, USA 2 Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN, USA 3 University of Michigan, Ann Arbor, Michigan, USA |
AuthorAffiliation_xml | – name: 1 Leukemia Department, MD Anderson Cancer Center, Houston, TX, USA – name: 2 Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN, USA – name: 3 University of Michigan, Ann Arbor, Michigan, USA |
Author_xml | – sequence: 1 givenname: Srdan surname: VERSTOVSEK fullname: VERSTOVSEK, Srdan organization: Leukemia Department, M. D. Anderson Cancer Center, Houston, Texas, United States – sequence: 2 givenname: Ayalew surname: TEFFERI fullname: TEFFERI, Ayalew organization: Division of Hematology, Mayo Clinic College of Medicine, Rochester, Minnesota, United States – sequence: 3 givenname: Hagop surname: KANTARJIAN fullname: KANTARJIAN, Hagop organization: Leukemia Department, M. D. Anderson Cancer Center, Houston, Texas, United States – sequence: 4 givenname: Jorge surname: CORTES fullname: CORTES, Jorge organization: Leukemia Department, M. D. Anderson Cancer Center, Houston, Texas, United States – sequence: 5 givenname: Susan surname: O'BRIEN fullname: O'BRIEN, Susan organization: Leukemia Department, M. D. Anderson Cancer Center, Houston, Texas, United States – sequence: 6 givenname: Guillermo surname: GARCIA-MANERO fullname: GARCIA-MANERO, Guillermo organization: Leukemia Department, M. D. Anderson Cancer Center, Houston, Texas, United States – sequence: 7 givenname: Animesh surname: PARDANANI fullname: PARDANANI, Animesh organization: Division of Hematology, Mayo Clinic College of Medicine, Rochester, Minnesota, United States – sequence: 8 givenname: Cem surname: AKIN fullname: AKIN, Cem organization: University of Michigan, Ann Arbor, Michigan, United States – sequence: 9 givenname: Stefan surname: FADERL fullname: FADERL, Stefan organization: Leukemia Department, M. D. Anderson Cancer Center, Houston, Texas, United States – sequence: 10 givenname: Taghi surname: MANSHOURI fullname: MANSHOURI, Taghi organization: Leukemia Department, M. D. Anderson Cancer Center, Houston, Texas, United States – sequence: 11 givenname: Deborah surname: THOMAS fullname: THOMAS, Deborah organization: Leukemia Department, M. D. Anderson Cancer Center, Houston, Texas, United States |
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Keywords | Chromosomal aberration Antineoplastic agent Human Dasatinib Mastocytosis Tyrosine kinase inhibitor Chronic disease Acute Philadelphia chromosome Abnormal chromosome C9 Treatment Phase II trial Systemic disease Abnormal chromosome G22 Abnormal chromosome Multikinase inhibitor |
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Snippet | Purpose: Molecular characterization of Philadelphia chromosome–negative (Ph−) chronic myeloproliferative disorders, such as systemic
mastocytosis (SM), has... Molecular characterization of Philadelphia chromosome-negative (Ph-) chronic myeloproliferative disorders, such as systemic mastocytosis (SM), has provided a... Abstract Purpose: Molecular characterization of Philadelphia chromosome–negative (Ph−) chronic myeloproliferative disorders, such as systemic mastocytosis... PURPOSE: Molecular characterization of Philadelphia chromosome-negative (Ph-) chronic myeloproliferative disorders, such as systemic mastocytosis (SM), has... Molecular characterization of Philadelphia chromosome-negative (Ph−) chronic myeloproliferative disorders, such as systemic mastocytosis (SM), has provided a... |
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SubjectTerms | acute myeloid leukemia Adult Aged Antineoplastic agents Antineoplastic Agents - adverse effects Antineoplastic Agents - therapeutic use Biological and medical sciences Dasatinib Female Humans hypereosinophilic syndrome Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy Leukemia, Myeloid, Acute - drug therapy Male Mastocytosis, Systemic - drug therapy Medical sciences Middle Aged myelodysplastic syndrome Pharmacology. Drug treatments Philadelphia Chromosome primary myelofibrosis Pyrimidines - adverse effects Pyrimidines - therapeutic use Remission Induction systemic mastocytosis Thiazoles - adverse effects Thiazoles - therapeutic use Treatment Outcome |
Title | Phase II Study of Dasatinib in Philadelphia Chromosome–Negative Acute and Chronic Myeloid Diseases, Including Systemic Mastocytosis |
URI | http://clincancerres.aacrjournals.org/content/14/12/3906.abstract https://www.ncbi.nlm.nih.gov/pubmed/18559612 https://search.proquest.com/docview/20929683 https://pubmed.ncbi.nlm.nih.gov/PMC5018899 |
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