A combination of chemotherapy with dasatinib is effective in achieving long-term remission for patients with newly diagnosed Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL), a new study published online ahead of print in the journal Cancer has shown.1
For the study, researchers enrolled 72 patients with Ph+ ALL. All participants received dasatinib with 8 cycles of alternating hyperfractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone, and high-dose cytarabine with methotrexate.
Those who achieved complete remission continued maintenance dasatinib plus vincristine and prednisone for 2 years, followed by dasatinib indefinitely. If patients were eligible to undergo allogeneic stem cell transplantation, they received it during their first complete response.
Results showed 96% achieved a complete response. Of those, 83% achieved cytogenetic complete response after 1 cycle and 93% achieved a major molecular response at a median of 4 weeks.
Researchers found that 94% of patients were negative for minimal residual disease at a median of 3 weeks. The median disease-free survival and overall survival were 31 months and 47 months, respectively.
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At a median follow-up of 67 months, 46% were alive and 43% were in complete response.
In regard to safety, the most common dasatinib-associated grade 3 and 4 adverse events included bleeding, pleural/pericardial effusions, and elevated transaminases.
- Ravandi F, O’Brien SM, Cortes JE, et al; Long-term follow-up of a phase 2 study of chemotherapy plus dasatinib for the initial treatment of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia [published online ahead of print August 26, 2015]. Cancer. doi: 10.1002/cncr.29646.