Nilotinib dose-optimization in newly diagnosed chronic myeloid leukaemia in chronic phase: Final results from ENESTxtnd

Timothy P Hughes, Eduardo Munhoz, Marco Aurelio Salvino, Tee Chuan Ong, Alaa Elhaddad, Jake Shortt, Hang Quach, Carolina Pavlovsky, Vernon J. Louw, Lee-Yung Shih, Anna G. Turkina, Luis Meillon, Yu Jin, Sandip Acharya, Darshan Dalal, Jeffrey H. Lipton

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8 Citations (Scopus)

Abstract

The Evaluating Nilotinib Efficacy and Safety in Clinical Trials-Extending Molecular Responses (ENESTxtnd) study was conducted to evaluate the kinetics of molecular response to nilotinib in patients with newly diagnosed chronic myeloid leukaemia in chronic phase and the impact of novel dose-optimization strategies on patient outcomes. The ENESTxtnd protocol allowed nilotinib dose escalation (from 300 to 400 mg twice daily) in the case of suboptimal response or treatment failure as well as dose re-escalation for patients with nilotinib dose reductions due to adverse events. Among 421 patients enrolled in ENESTxtnd, 70·8% (95% confidence interval, 66·2-75·1%) achieved major molecular response (BCR-ABL1 ≤ 0·1% on the International Scale) by 12 months (primary endpoint). By 24 months, 81·0% of patients achieved major molecular response, including 63·6% (56 of 88) of those with dose escalations for lack of efficacy and 74·3% (55 of 74) of those with dose reductions due to adverse events (including 43 of 54 patients with successful re-escalation). The safety profile of nilotinib was consistent with prior studies. The most common non-haematological adverse events were headache, rash, and nausea; cardiovascular events were reported in 4·5% of patients (grade 3/4, 3·1%). The study was registered at clinicaltrials.gov (NCT01254188).

Original languageEnglish
Pages (from-to)219-228
Number of pages10
JournalBritish Journal of Haematology
Volume179
Issue number2
DOIs
Publication statusPublished - Oct 2017

Keywords

  • Chronic myeloid leukaemia
  • Dose optimization
  • Molecular response
  • Nilotinib
  • Tyrosine kinase inhibitor

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