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Blood, 1 October 2007, Vol. 110, No. 7, pp. 2309-2315.
Prepublished online as a Blood First Edition Paper on May 11, 2007; DOI 10.1182/blood-2007-02-073528.
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Submitted February 9, 2007
Accepted April 14, 2007
Dasatinib induces rapid hematologic and cytogenetic responses in adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia with resistance or intolerance to imatinib: interim results of a Phase II study
Oliver Ottmann*, Herve Dombret, Giovanni Martinelli, Bengt Simonsson, Francois Guilhot, Richard A Larson, Giovanna Rege-Cambrin, Jerald Radich, Andreas Hochhaus, Anne Marie Apanovitch, Ashwin Gollerkeri, and Steven Coutre
Medizinische Klinik II, Johann Wolfgang Goethe Universitat, Frankfurt, Germany
Hospital Saint Louis, Paris, France
Istituto di Ematologica E Oncologica Medica, Policlinico S Orsola, Bologna, Italy
Dept of Hematology, University Hospital, Uppsala, Sweden
Clinical Research Centre, CHU la Miletrie, Poitiers, France
University of Chicago, Chicago, IL, United States
Dipartimento di Medicina Interna ii ed Ematologia, Azienda Ospedaliera S.Luigi, Orbassano, Italy
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
Medizinische Fakultat Mannheim, Universitat Heidelberg, Mannheim, Germany
Bristol-Myers Squibb, Hopewell, NJ, United States
Bristol-Myers Squibb, Wallingford, CT, United States
Stanford University School of Medicine, Stanford, CA, United States
* Corresponding author; email: ottmann{at}em.uni-frankfurt.de.
Patients with Philadelphia chromosome (Ph)-positive acute lymphoblastic leukemia (ALL) generally have a rapid disease course and a poor overall prognosis. Dasatinib, a novel, oral, multi-targeted kinase inhibitor of BCR-ABL and SRC family kinases, has previously induced responses in patients with imatinib-resistant or -intolerant Ph-positive ALL. Here, we present the interim results of a Phase II study designed to further assess the efficacy, safety, and tolerability of dasatinib 140 mg in this patient population (N=36). With a minimum follow-up of 8 months, treatment with dasatinib resulted in substantial hematologic and cytogenetic response rates. Major hematologic responses were achieved in 42% of patients (15/36 patients), 67% of whom remained progression-free. Complete cytogenetic responses were attained by 58% of patients (21/36). Importantly, the presence of BCR-ABL mutations conferring imatinib-resistance did not preclude a response to dasatinib. Dasatinib was also tolerable, with 6% of patients (2/36) discontinuing therapy as a result of study-drug toxicity. Most adverse events (AEs) were Grade 1 or 2; febrile neutropenia was the most frequent severe AE, but this and other cytopenias were manageable with dose reduction. Dasatinib represents a safe and effective treatment option and represents an important therapeutic advance for patients with Ph-positive ALL.

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