Nilotinib as Initial Therapy for Patients with CML

Imatinib mesylate therapy induces durable cytogenetic remissions in most patients with chronic-phase chronic myeloid leukemia (CML), but some patients cannot tolerate imatinib, do not initially respond, or cannot sustain a response. The second-generation tyrosine kinase inhibitor nilotinib more potently inhibits the BCR-ABL fusion protein in vitro than does imatinib. In addition, nilotinib remains active against most imatinib-resistant BCR-ABL mutations and therefore is approved for use in patients whose disease is resistant to imatinib. These attributes have fueled interest in nilotinib as initial therapy in patients with chronic-phase CML. Two clinical trials to assess nilotinib 400 mg twice daily in a total of 124 evaluable patients with…