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Blood, 15 March 2002, Vol. 99, No. 6, pp. 1928-1937

CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS

Imatinib induces durable hematologic and cytogenetic responses in patients with accelerated phase chronic myeloid leukemia: results of a phase 2 study

Moshe Talpaz, Richard T. Silver, Brian J. Druker, John M. Goldman, Carlo Gambacorti-Passerini, Francois Guilhot, Charles A. Schiffer, Thomas Fischer, Michael W. N. Deininger, Anne L. Lennard, Andreas Hochhaus, Oliver G. Ottmann, Alois Gratwohl, Michele Baccarani, Richard Stone, Sante Tura, Francois-Xavier Mahon, Sofia Fernandes-Reese, Insa Gathmann, Renaud Capdeville, Hagop M. Kantarjian, and Charles L. Sawyers

From the M. D. Anderson Cancer Center, Houston, TX; New York-Presbyterian Hospital Weill Medical College of Cornell University, New York, NY; Division of Hematology, Oregon Health Sciences University, Portland; Department of Haematology, Hammersmith Hospital/ICSM, London, United Kingdom; Hematology Section, San Gerardo Hospital, Monza, Italy; Department of Experimental Oncology, National Cancer Institute, Milan, Italy; Department of Oncology Hematology and Cell Therapy, C.H.U de Poitiers, Poitiers, France; Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI; Universitätsklinikum, Medizinische Klinik und Poliklinik, Mainz, Germany; Abteilung Haematologie/Onkologie, Universität Leipzig, Leipzig, Germany; Department of Haematology, Royal Victoria Infirmary, University of Newcastle upon Tyne, United Kingdom; Medizinische Universitätsklinik Mannheim der Universität Heidelberg, Mannheim, Germany; Medizinische Klinik III, Johan Wolfgang Goethe Universität, Frankfurt, Germany; Division of Hematology, Universitätsklinik, Kantonspital, Basel, Switzerland; Division of Hematology, Udine University Hospital, Udine, Italy; Dana Farber Cancer Institute, Boston, MA; Instituto di Ematologia, Ospedale Policlinicl Sant'Orsola-Malpighi, Bologna, Italy; Laboratoire de Greffe de Moelle, Universite Victor Segalen, Bordeaux, France; Novartis Pharma AG, Basel, Switzerland; Department of Medicine and Molecular Biology Institute, University of California at Los Angeles, CA.

Chronic myelogenous leukemia (CML) is caused by expression of the BCR-ABL tyrosine kinase oncogene, the product of the t(9;22) Philadelphia translocation. Patients with CML in accelerated phase have rapidly progressive disease and are characteristically unresponsive to existing therapies. Imatinib (formerly STI571) is a rationally developed, orally administered inhibitor of the Bcr-Abl kinase. A total of 235 CML patients were enrolled in this study, of whom 181 had a confirmed diagnosis of accelerated phase. Patients were treated with imatinib at 400 or 600 mg/d and were evaluated for hematologic and cytogenetic response, time to progression, survival, and toxicity. Imatinib induced hematologic response in 82% of patients and sustained hematologic responses lasting at least 4 weeks in 69% (complete in 34%). The rate of major cytogenetic response was 24% (complete in 17%). Estimated 12-month progression-free and overall survival rates were 59% and 74%, respectively. Nonhematologic toxicity was usually mild or moderate, and hematologic toxicity was manageable. In comparison to 400 mg, imatinib doses of 600 mg/d led to more cytogenetic responses (28% compared to 16%), longer duration of response (79% compared to 57% at 12 months), time to disease progression (67% compared to 44% at 12 months), and overall survival (78% compared to 65% at 12 months), with no clinically relevant increase in toxicity. Orally administered imatinib is an effective and well-tolerated treatment for patients with CML in accelerated phase. A daily dose of 600 mg is more effective than 400 mg, with similar toxicity.

© 2002 by The American Society of Hematology.
 

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Anaplastic lymphoma kinase is a dependence receptor whose proapoptotic functions are activated by caspase cleavage.
Mol. Cell. Biol., August 1, 2006; 26(16): 6209 - 6222.
[Abstract] [Full Text] [PDF]


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BloodHome page
D. Ye, N. Wolff, L. Li, S. Zhang, and R. L. Ilaria Jr
STAT5 signaling is required for the efficient induction and maintenance of CML in mice
Blood, June 15, 2006; 107(12): 4917 - 4925.
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Cancer Res.Home page
J. S. Tokarski, J. A. Newitt, C. Y. J. Chang, J. D. Cheng, M. Wittekind, S. E. Kiefer, K. Kish, F. Y.F. Lee, R. Borzillerri, L. J. Lombardo, et al.
The Structure of Dasatinib (BMS-354825) Bound to Activated ABL Kinase Domain Elucidates Its Inhibitory Activity against Imatinib-Resistant ABL Mutants
Cancer Res., June 1, 2006; 66(11): 5790 - 5797.
[Abstract] [Full Text] [PDF]


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JCOHome page
P. Ault, H. Kantarjian, S. O'Brien, S. Faderl, M. Beran, M. B. Rios, C. Koller, F. Giles, M. Keating, M. Talpaz, et al.
Pregnancy Among Patients With Chronic Myeloid Leukemia Treated With Imatinib
J. Clin. Oncol., March 1, 2006; 24(7): 1204 - 1208.
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Ann OncolHome page
G. Martinelli, I. Iacobucci, G. Rosti, F. Pane, M. Amabile, F. Castagnetti, D. Cilloni, S. Soverini, N. Testoni, G. Specchia, et al.
Prediction of response to imatinib by prospective quantitation of BCR-ABL transcript in late chronic phase chronic myeloid leukemia patients
Ann. Onc., March 1, 2006; 17(3): 495 - 502.
[Abstract] [Full Text] [PDF]


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Mayo Clin Proc.Home page
M. J. Mauro and R. T. Maziarz
Stem Cell Transplantation in Patients With Chronic Myelogenous Leukemia: When Should It Be Used?
Mayo Clin. Proc., March 1, 2006; 81(3): 404 - 416.
[Abstract] [Full Text] [PDF]


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BloodHome page
A. Aloisi, S. Di Gregorio, F. Stagno, P. Guglielmo, F. Mannino, M. P. Sormani, P. Bruzzi, C. Gambacorti-Passerini, G. Saglio, S. Venuta, et al.
BCR-ABL nuclear entrapment kills human CML cells: ex vivo study on 35 patients with the combination of imatinib mesylate and leptomycin B
Blood, February 15, 2006; 107(4): 1591 - 1598.
[Abstract] [Full Text] [PDF]


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JCOHome page
I. Iacobucci, G. Rosti, M. Amabile, A. Poerio, S. Soverini, D. Cilloni, N. Testoni, E. Abruzzese, E. Montefusco, E. Ottaviani, et al.
Comparison Between Patients With Philadelphia-Positive Chronic Phase Chronic Myeloid Leukemia Who Obtained a Complete Cytogenetic Response Within 1 Year of Imatinib Therapy and Those Who Achieved Such a Response After 12 Months of Treatment
J. Clin. Oncol., January 20, 2006; 24(3): 454 - 459.
[Abstract] [Full Text] [PDF]


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JCOHome page
D. A. Reardon, M. J. Egorin, J. A. Quinn, J. N. Rich Sr, I. Gururangan, J. J. Vredenburgh, A. Desjardins, S. Sathornsumetee, J. M. Provenzale, J. E. Herndon II, et al.
Phase II Study of Imatinib Mesylate Plus Hydroxyurea in Adults With Recurrent Glioblastoma Multiforme
J. Clin. Oncol., December 20, 2005; 23(36): 9359 - 9368.
[Abstract] [Full Text] [PDF]


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JCOHome page
G. Hess, D. Bunjes, W. Siegert, R. Schwerdtfeger, G. Ledderose, B. Wassmann, G. Kobbe, M. Bornhauser, A. Hochhaus, A. J. Ullmann, et al.
Sustained Complete Molecular Remissions After Treatment With Imatinib-Mesylate in Patients With Failure After Allogeneic Stem Cell Transplantation for Chronic Myelogenous Leukemia: Results of a Prospective Phase II Open-Label Multicenter Study
J. Clin. Oncol., October 20, 2005; 23(30): 7583 - 7593.
[Abstract] [Full Text] [PDF]


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Ann OncolHome page
G. Dresemann
Imatinib and hydroxyurea in pretreated progressive glioblastoma multiforme: a patient series
Ann. Onc., October 1, 2005; 16(10): 1702 - 1708.
[Abstract] [Full Text] [PDF]


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Clin. Cancer Res.Home page
T. O'Hare, D. K. Walters, E. P. Stoffregen, D. W. Sherbenou, M. C. Heinrich, M. W.N. Deininger, and B. J. Druker
Combined Abl Inhibitor Therapy for Minimizing Drug Resistance in Chronic Myeloid Leukemia: Src/Abl Inhibitors Are Compatible with Imatinib
Clin. Cancer Res., October 1, 2005; 11(19): 6987 - 6993.
[Abstract] [Full Text] [PDF]


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BloodHome page
S. G. Willis, T. Lange, S. Demehri, S. Otto, L. Crossman, D. Niederwieser, E. P. Stoffregen, S. McWeeney, I. Kovacs, B. Park, et al.
High-sensitivity detection of BCR-ABL kinase domain mutations in imatinib-naive patients: correlation with clonal cytogenetic evolution but not response to therapy
Blood, September 15, 2005; 106(6): 2128 - 2137.
[Abstract] [Full Text] [PDF]


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Clin. Cancer Res.Home page
M. Talpaz, A. Rakhit, K. Rittweger, S. O'Brien, J. Cortes, S. Fettner, L. Hooftman, and H. Kantarjian
Phase I Evaluation of a 40-kDa Branched-Chain Long-Acting Pegylated IFN-{alpha}-2a With and Without Cytarabine in Patients with Chronic Myelogenous Leukemia
Clin. Cancer Res., September 1, 2005; 11(17): 6247 - 6255.
[Abstract] [Full Text] [PDF]


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Clin. Chem.Home page
N. Sorel, F. Chazelas, A. Brizard, and J.-C. Chomel
Double-Gradient-Denaturing-Gradient Gel Electrophoresis for Mutation Screening of the BCR-ABL Tyrosine Kinase Domain in Chronic Myeloid Leukemia Patients
Clin. Chem., July 1, 2005; 51(7): 1263 - 1266.
[Full Text] [PDF]


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Clin. Cancer Res.Home page
M. Golemovic, S. Verstovsek, F. Giles, J. Cortes, T. Manshouri, P. W. Manley, J. Mestan, M. Dugan, L. Alland, J. D. Griffin, et al.
AMN107, a Novel Aminopyrimidine Inhibitor of Bcr-Abl, Has In vitro Activity against Imatinib-Resistant Chronic Myeloid Leukemia
Clin. Cancer Res., July 1, 2005; 11(13): 4941 - 4947.
[Abstract] [Full Text] [PDF]


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JCOHome page
S. Soverini, G. Martinelli, G. Rosti, S. Bassi, M. Amabile, A. Poerio, B. Giannini, E. Trabacchi, F. Castagnetti, N. Testoni, et al.
ABL Mutations in Late Chronic Phase Chronic Myeloid Leukemia Patients With Up-Front Cytogenetic Resistance to Imatinib Are Associated With a Greater Likelihood of Progression to Blast Crisis and Shorter Survival: A Study by the GIMEMA Working Party on Chronic Myeloid Leukemia
J. Clin. Oncol., June 20, 2005; 23(18): 4100 - 4109.
[Abstract] [Full Text] [PDF]


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JCOHome page
J.-P. J. Issa, V. Gharibyan, J. Cortes, J. Jelinek, G. Morris, S. Verstovsek, M. Talpaz, G. Garcia-Manero, and H. M. Kantarjian
Phase II Study of Low-Dose Decitabine in Patients With Chronic Myelogenous Leukemia Resistant to Imatinib Mesylate
J. Clin. Oncol., June 10, 2005; 23(17): 3948 - 3956.
[Abstract] [Full Text] [PDF]


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Cancer Res.Home page
T. O'Hare, D. K. Walters, E. P. Stoffregen, T. Jia, P. W. Manley, J. Mestan, S. W. Cowan-Jacob, F. Y. Lee, M. C. Heinrich, M. W.N. Deininger, et al.
In vitro Activity of Bcr-Abl Inhibitors AMN107 and BMS-354825 against Clinically Relevant Imatinib-Resistant Abl Kinase Domain Mutants
Cancer Res., June 1, 2005; 65(11): 4500 - 4505.
[Abstract] [Full Text] [PDF]


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BloodHome page
N. C. Wolff, D. R. Veach, W. P. Tong, W. G. Bornmann, B. Clarkson, and R. L. Ilaria Jr
PD166326, a novel tyrosine kinase inhibitor, has greater antileukemic activity than imatinib mesylate in a murine model of chronic myeloid leukemia
Blood, May 15, 2005; 105(10): 3995 - 4003.
[Abstract] [Full Text] [PDF]


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BloodHome page
P.-H. Tseng, H.-P. Lin, J. Zhu, K.-F. Chen, E. M. Hade, D. C. Young, J. C. Byrd, M. Grever, K. Johnson, B. J. Druker, et al.
Synergistic interactions between imatinib mesylate and the novel phosphoinositide-dependent kinase-1 inhibitor OSU-03012 in overcoming imatinib mesylate resistance
Blood, May 15, 2005; 105(10): 4021 - 4027.
[Abstract] [Full Text] [PDF]


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BloodHome page
M. Deininger, E. Buchdunger, and B. J. Druker
The development of imatinib as a therapeutic agent for chronic myeloid leukemia
Blood, April 1, 2005; 105(7): 2640 - 2653.
[Abstract] [Full Text] [PDF]


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BloodHome page
A. Quintas-Cardama, H. Kantarjian, M. Talpaz, S. O'Brien, G. Garcia-Manero, S. Verstovsek, M. B. Rios, K. Hayes, A. Glassman, B. N. Bekele, et al.
Imatinib mesylate therapy may overcome the poor prognostic significance of deletions of derivative chromosome 9 in patients with chronic myelogenous leukemia
Blood, March 15, 2005; 105(6): 2281 - 2286.
[Abstract] [Full Text] [PDF]


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Clin. Cancer Res.Home page
S. Appel, A. Rupf, M. M. Weck, O. Schoor, T. H. Brummendorf, T. Weinschenk, F. Grunebach, and P. Brossart
Effects of Imatinib on Monocyte-Derived Dendritic Cells Are Mediated by Inhibition of Nuclear Factor-{kappa}B and Akt Signaling Pathways
Clin. Cancer Res., March 1, 2005; 11(5): 1928 - 1940.
[Abstract] [Full Text] [PDF]


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BloodHome page
S. Chu, H. Xu, N. P. Shah, D. S. Snyder, S. J. Forman, C. L. Sawyers, and R. Bhatia
Detection of BCR-ABL kinase mutations in CD34+ cells from chronic myelogenous leukemia patients in complete cytogenetic remission on imatinib mesylate treatment
Blood, March 1, 2005; 105(5): 2093 - 2098.
[Abstract] [Full Text] [PDF]


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JCOHome page
H. B. Koon, G. J. Bubley, L. Pantanowitz, D. Masiello, B. Smith, K. Crosby, J. Proper, W. Weeden, T. E. Miller, P. Chatis, et al.
Imatinib-Induced Regression of AIDS-Related Kaposi's Sarcoma
J. Clin. Oncol., February 10, 2005; 23(5): 982 - 989.
[Abstract] [Full Text] [PDF]


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Clin. Cancer Res.Home page
M. H. Cohen, J. R. Johnson, and R. Pazdur
U.S. Food and Drug Administration Drug Approval Summary: Conversion of Imatinib Mesylate (STI571; Gleevec) Tablets from Accelerated Approval to Full Approval
Clin. Cancer Res., January 1, 2005; 11(1): 12 - 19.
[Abstract] [Full Text] [PDF]


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BloodHome page
M. Wadleigh, D. J. DeAngelo, J. D. Griffin, and R. M. Stone
After chronic myelogenous leukemia: tyrosine kinase inhibitors in other hematologic malignancies
Blood, January 1, 2005; 105(1): 22 - 30.
[Abstract] [Full Text] [PDF]


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BloodHome page
T. Yin, Y.-L. Wu, H.-P. Sun, G.-L. Sun, Y.-Z. Du, K.-K. Wang, J. Zhang, G.-Q. Chen, S.-J. Chen, and Z. Chen
Combined effects of As4S4 and imatinib on chronic myeloid leukemia cells and BCR-ABL oncoprotein
Blood, December 15, 2004; 104(13): 4219 - 4225.
[Abstract] [Full Text] [PDF]


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BloodHome page
M. Baccarani, G. Martinelli, G. Rosti, E. Trabacchi, N. Testoni, S. Bassi, M. Amabile, S. Soverini, F. Castagnetti, D. Cilloni, et al.
Imatinib and pegylated human recombinant interferon-{alpha}2b in early chronic-phase chronic myeloid leukemia
Blood, December 15, 2004; 104(13): 4245 - 4251.
[Abstract] [Full Text] [PDF]


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BloodHome page
M. Towatari, M. Yanada, N. Usui, J. Takeuchi, I. Sugiura, M. Takeuchi, F. Yagasaki, Y. Kawai, S. Miyawaki, S. Ohtake, et al.
Combination of intensive chemotherapy and imatinib can rapidly induce high-quality complete remission for a majority of patients with newly diagnosed BCR-ABL-positive acute lymphoblastic leukemia
Blood, December 1, 2004; 104(12): 3507 - 3512.
[Abstract] [Full Text] [PDF]


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BloodHome page
M. A. Champagne, R. Capdeville, M. Krailo, W. Qu, B. Peng, M. Rosamilia, M. Therrien, U. Zoellner, S. M. Blaney, and M. Bernstein
Imatinib mesylate (STI571) for treatment of children with Philadelphia chromosome-positive leukemia: results from a Children's Oncology Group phase 1 study
Blood, November 1, 2004; 104(9): 2655 - 2660.
[Abstract] [Full Text] [PDF]


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BloodHome page
S. Branford, Z. Rudzki, I. Parkinson, A. Grigg, K. Taylor, J. F. Seymour, S. Durrant, P. Browett, A. P. Schwarer, C. Arthur, et al.
Real-time quantitative PCR analysis can be used as a primary screen to identify patients with CML treated with imatinib who have BCR-ABL kinase domain mutations
Blood, November 1, 2004; 104(9): 2926 - 2932.
[Abstract] [Full Text] [PDF]


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BloodHome page
T. O'Hare, R. Pollock, E. P. Stoffregen, J. A. Keats, O. M. Abdullah, E. M. Moseson, V. M. Rivera, H. Tang, C. A. Metcalf III, R. S. Bohacek, et al.
Inhibition of wild-type and mutant Bcr-Abl by AP23464, a potent ATP-based oncogenic protein kinase inhibitor: implications for CML
Blood, October 15, 2004; 104(8): 2532 - 2539.
[Abstract] [Full Text] [PDF]


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BloodHome page
H. M. Kantarjian, J. E. Cortes, S. O'Brien, R. Luthra, F. Giles, S. Verstovsek, S. Faderl, D. Thomas, G. Garcia-Manero, M. B. Rios, et al.
Long-term survival benefit and improved complete cytogenetic and molecular response rates with imatinib mesylate in Philadelphia chromosome-positive chronic-phase chronic myeloid leukemia after failure of interferon-{alpha}
Blood, October 1, 2004; 104(7): 1979 - 1988.
[Abstract] [Full Text] [PDF]


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BloodHome page
K. S. Baker, J. G. Gurney, K. K. Ness, R. Bhatia, S. J. Forman, L. Francisco, P. B. McGlave, L. L. Robison, D. S. Snyder, D. J. Weisdorf, et al.
Late effects in survivors of chronic myeloid leukemia treated with hematopoietic cell transplantation: results from the Bone Marrow Transplant Survivor Study
Blood, September 15, 2004; 104(6): 1898 - 1906.
[Abstract] [Full Text] [PDF]


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BloodHome page
P. F. Smith, J. M. Bullock, B. M. Booker, C. E. Haas, C. S. Berenson, and W. J. Jusko
Induction of imatinib metabolism by hypericum perforatum
Blood, August 15, 2004; 104(4): 1229 - 1230.
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Clin. Chem.Home page
J. A.E. Irving, S. O'Brien, A. L. Lennard, L. Minto, F. Lin, and A. G. Hall
Use of Denaturing HPLC for Detection of Mutations in the BCR-ABL Kinase Domain in Patients Resistant to Imatinib
Clin. Chem., July 1, 2004; 50(7): 1233 - 1237.
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Clin. Chem.Home page
S. Soverini, G. Martinelli, M. Amabile, A. Poerio, M. Bianchini, G. Rosti, F. Pane, G. Saglio, and M. Baccarani
Denaturing-HPLC-Based Assay for Detection of ABL Mutations in Chronic Myeloid Leukemia Patients Resistant to Imatinib
Clin. Chem., July 1, 2004; 50(7): 1205 - 1213.
[Abstract] [Full Text] [PDF]


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BloodHome page
D. A. Thomas, S. Faderl, J. Cortes, S. O'Brien, F. J. Giles, S. M. Kornblau, G. Garcia-Manero, M. J. Keating, M. Andreeff, S. Jeha, et al.
Treatment of Philadelphia chromosome-positive acute lymphocytic leukemia with hyper-CVAD and imatinib mesylate
Blood, June 15, 2004; 103(12): 4396 - 4407.
[Abstract] [Full Text] [PDF]


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Clin. Cancer Res.Home page
J. W. Park, R. S. Kerbel, G. J. Kelloff, J. C. Barrett, B. A. Chabner, D. R. Parkinson, J. Peck, R. W. Ruddon, C. C. Sigman, and D. J. Slamon
Rationale for Biomarkers and Surrogate End Points in Mechanism-Driven Oncology Drug Development
Clin. Cancer Res., June 1, 2004; 10(11): 3885 - 3896.
[Full Text] [PDF]


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The OncologistHome page
R. M. Stone
Optimizing Treatment of Chronic Myeloid Leukemia: A Rational Approach
Oncologist, June 1, 2004; 9(3): 259 - 270.
[Abstract] [Full Text] [PDF]


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The OncologistHome page
F. Guilhot
Indications for Imatinib Mesylate Therapy and Clinical Management
Oncologist, June 1, 2004; 9(3): 271 - 281.
[Abstract] [Full Text] [PDF]



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