Efficacy and safety of nilotinib as frontline treatment in elderly (> 65 years) chronic myeloid leukemia patients outside clinical trials

Luigia Luciano, Roberto Latagliata, Gabriele Gugliotta, Mario Annunziata, Mario Tiribelli, Bruno Martino, Antonello Sica, Maria Rosaria Esposito, Monica Bocchia, Sara Galimberti, Federica Sora', Francesco Albano, Raffaele Palmieri, Patrizia Pregno, Matteo Dragani, Maria Iovine, Simona Sica, Alessandra Iurlo, Fausto Castagnetti, Gianantonio RostiMassimo Breccia

Research output: Contribution to journalArticle

Abstract

Here, we report real-world evidence on the safety and efficacy of nilotinib as a first-line treatment in elderly patients with chronic phase CML, treated in 18 Italian centers. Sixty patients aged > 65 years (median age 72 years (65–84)) were reported: 13 patients were older than 75 years. Comorbidities were recorded at baseline in 56/60 patients. At 3 months of treatment, all patients obtained complete hematological response (CHR), 43 (71.6%) an early molecular response (EMR), while 47 (78%) reached a complete cytogenetic response (CCyR). At last follow-up, 63.4% of patients still had a deep molecular response (MR4 or better), 21.6% reached MR3 as best response and 11.6% persisted without MR. Most patients (85%) started the treatment at the standard dose (300 mg BID), maintained at 3 months in 80% of patients and at 6 months in 89% of them. At the last median follow-up of 46.3 months, 15 patients discontinued definitively the treatment (8 due to side effects, 4 died for unrelated CML causes, 1 for failure, 2 were lost to follow-up). One patient entered in treatment-free remission. As to safety, 6 patients (10%) experienced cardiovascular events after a median time of 20.9 months from the start. Our data showed that nilotinib could be, as first-line treatment, effective and relatively safe even in elderly CML patients. In this setting, more data in the long term are needed about possible dose reduction to improve the tolerability, while maintaining the optimal molecular response.
Original languageEnglish
Pages (from-to)1375-1382
Number of pages8
JournalAnnals of Hematology
Volume102
DOIs
Publication statusPublished - 2023

Keywords

  • Chronic myeloid leukemia
  • Nilotinib
  • Elderly
  • Efficacy and safety

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