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Treatment with Tyrosine Kinase Inhibitors

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Myeloproliferative Disorders

Part of the book series: Hematologic Malignancies ((HEMATOLOGIC))

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Abstract

Leukemias have traditionally served as model systems for research on neoplasia because of the easy availability of cell material from blood and marrow for diagnosis, monitoring, and studies on pathophysiology. Beyond these more technical aspects, chronic myeloid leukemia (CML) became the first neoplasia in which the elucidation of the genotype led to a rationally designed therapy of the phenotype. Targeting of the pathogenetically relevant Bcr-Abl tyrosine kinase with the inhibitor imatinib has induced remissions with almost complete disappearance of any signs and symptoms of CML. This therapeutic success has triggered an intensive search for suitable targets in other cancers and has led to the development of numerous inhibitors of potential targets now being studied in preclinical and clinical trials worldwide. Imatinib mesylate has been the first selective inhibitor of Bcr-Abl employed in patients. Its routine use has been considered a revolution in the treatment of CML.

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References

  • Anstrom KJ, Reed SD, Allen AS, Glendenning GA, Schulman KA (2004) Long-term survival estimates for imatinib versus interferon-alpha plus low-dose cytarabine for patients with newly diagnosed chronic-phase chronic myeloid leukemia. Cancer 101:2584–2592

    Article  PubMed  CAS  Google Scholar 

  • Baccarani M, Martinelli G, Rosti G, Trabacchi E, Testoni N, Bassi S, Amabile M, Soverini S, Castagnetti F, Cilloni D, Izzo B, de Vivo A, Messa E, Bonifazi F, Poerio A, Luatti S, Giugliano E, Alberti D, Fincato G, Russo D, Pane F, Saglio G (2004) GIMEMA Working Party on Chronic Myeloid Leukemia. Imatinib and pegylated human reacombinant interferon-a2b in early CP chronic myeloid leukemia. Blood 104:4245–4251

    Article  PubMed  CAS  Google Scholar 

  • Berger U, Engelich G, Reiter A, Hochhaus A, Hehlmann R and the German CML Study Group (2004) Imatinib and beyond — the new CML-Study IV. A randomised controlled comparison of imatinib vs. imatinib/interferon-alpha vs. imatinib/low-dose AraC vs. interferon-alpha standard therapy in newly diagnosed CP chronic myeloid leukemia. Ann Hematol 83:258–264

    Article  PubMed  CAS  Google Scholar 

  • Bonifazi F, De Vivo A, Rosti G, Guilhot F, Guilhot J, Trabacchi E, Hehlmann R, Hochhaus A, Shepherd PCA, Steegmann JL, Kluin-Nelemans HC, Thaler J, Simonsson B, Louwagi A, Reiffers J, Mahon FX, Montefusco E, Alimena G, Hasford J, Richards S, Saglio G, Testoni N, Martinelli G, Tura S, Baccarani M for the European Study Group on Interferon in Chronic Myeloid Leukemia (2001) Chronic myeloid leukemia and interferon-alpha: a study of complete cytogenetic responders. Blood 98:3074–3081

    Article  PubMed  CAS  Google Scholar 

  • Branford S, Rudzki Z, Walsh S, Parkinson I, Grigg A, Szer J, Taylor K, Herrmann R, Seymour JF, Arthur C, Joske D, Lynch K, Hughes T (2003) Detection of BCR-ABL mutations in patients with CML treated with imatinib is virtually always accompanied by clinical resistance, and mutations in the ATP phosphate-binding loop (P-loop) are associated with a poor prognosis. Blood 102:276–283

    Article  PubMed  CAS  Google Scholar 

  • Buchdunger E, Cioffi CL, Law N, Stover D, Ohno-Jones S, Druker BJ, Lydon NB (2000) Abl protein-tyrosine kinase inhibitor STI571 inhibits in vitro signal transduction mediated by c-kit and platelet-derived growth factor receptors. J Pharmacol Exp Ther 295:139–145

    PubMed  CAS  Google Scholar 

  • Cortes J, Albitar M, Thomas D et al (2003) Efficacy of the farnesyl transferase inhibitor, Zarnestra (R115777), in chronic myeloid leukemia and other hematologic malignancies. Blood 101:1692–1697

    Article  PubMed  CAS  Google Scholar 

  • Cortes J, Giles F, O’Brien S, Thomas D, Garcia-Manero G, Rios MB, Faderl S, Verstovsek S, Ferrajoli A, Freireich EJ, Talpaz M, Kantarjian H (2003) Result of high-dose imatinib mesylate in patients with Philadelphia chromosome-positive chronic myeloid leukemia after failure of interferon-alpha. Blood 102:83–86

    Article  PubMed  CAS  Google Scholar 

  • Deininger MW, O’Brien SG, Ford JM, Druker BJ (2003) Practical management of patients with chronic myeloid leukemia receiving imatinib. J Clin Oncol 21:1637–1647

    Article  PubMed  CAS  Google Scholar 

  • Druker BJ, Tamura S, Buchdunger E, Ohno S, Segal GM, Fanning S, Zimmermann J, Lydon NB (1996) Effects of a selective inhibitor of the Abl tyrosine kinase on the growth of Bcr-Abl positive cells. Nat Med 2:561–566

    Article  PubMed  CAS  Google Scholar 

  • Druker BJ, Sawyers CL, Kantarjian H, Resta DJ, Reese SF, Ford JM, Capdeville R, Talpaz M (2001a) Activity of a specific inhibitor of the Bcr-Abl tyrosine kinase in the BC of chronic myeloid leukemia and acute lymphoblastic leukemia with the Philadelphia chromosome. N Engl J Med 344:1038–1042

    Article  PubMed  CAS  Google Scholar 

  • Druker BJ, Talpaz M, Resta DJ, Peng B, Buchdunger E, Ford JM, Lydon NB, Kantarjian H, Capdeville R, Ohno-Jones S, Sawyers CL (2001b) Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia. N Engl J Med 344:1031–1037

    Article  PubMed  CAS  Google Scholar 

  • Druker B, Guilhot F, O’Brien S, Larson R (2006) Long-term benefits of imatinib (IM) for patients newly diagnosed with chronic myelogenous leukemia in chronic phase (CML-CP): the 5-year update from the IRIS study. Proc ASCO 24:Abstract 6506

    Google Scholar 

  • Druker BJ, Gathmann I, Bolton AE, Larson R, on behalf of the IRIS Study Group (2003) Probability and impact of obtaining a cytogenetic response to imatinib as initial therapy for chronic myeloid leukemia (CML) in chronic phase. Blood 102:182a

    Google Scholar 

  • Garcia-Manero G, Faderl S, O’Brien S, Cortes J, Talpaz M, Kantarjian HM (2003) Chronic myelogenous leukemia: a review and update of therapeutic strategies. Cancer 98:437–457

    Article  PubMed  CAS  Google Scholar 

  • Goldman JM, Melo JV (2003) Chronic myeloid leukemia — advances in biology and new approaches to treatment. N Engl J Med 349: 1451–1464

    Article  PubMed  CAS  Google Scholar 

  • Graham SM, Jorgensen HG, Allan E, Pearson C, Alcorn MJ, Richmond L, Holyoake TL (2002) Primitive, quiescent, Philadelphia-positive stem cells from patients with chronic myeloid leukemia are insensitive to STI571 in vitro. Blood 99:319–325

    Article  PubMed  CAS  Google Scholar 

  • Guilhot F (2004) Sustained durability of responses plus high rates of cytogenetic responses result in long-term benefit for newly diagnosed chronic-phase chronic myeloid leukemia (CML-CP) treated with imatinib (IM) therapy: update from the IRIS study. Blood 104:11

    Article  Google Scholar 

  • Hahn EA, Glendenning GA, Sorensen MV, Hudgens SA, Druker BJ, Guilhot F, Larson RA, O’Brien SG, Dobrez DG, Hensley ML, Cella D, IRIS Investigators (2003) Quality of life in patients with newly diagnosed chronic phase chronic myeloid leukemia on imatinib versus interferon alfa plus low-dose cytarabine: results from the IRIS Study. J Clin Oncol 21:2138–2146

    Article  PubMed  CAS  Google Scholar 

  • Hasford J, Pfirrmann M, Hochhaus A (2005) How long will chronic phase CML pateints treated with imatinib live? Leukemia 19: 497–499

    Article  PubMed  CAS  Google Scholar 

  • Hehlmann R, Berger U, Pfirrmann M, Hochhaus A, Metzgeroth G, Maywald O, Hasford J, Reiter A, Hossfeld DK, Kolb HJ, Löffler H, Pralle H, Queisser W, Griesshammer M, Nerl C, Kuse R, Tobler A, Eimermacher H, Tichelli A, Aul C, Wilhelm M, Fischer JT, Perker M, Scheid C, Schenk M, Weiss J, Meier CR, Kremers S, Labedzki L, Schmeiser T, Lohrmann HP, Heimpel H, German CML-Study Group (2003) Randomized comparison of interferon alpha and hydroxyurea with hydroxyurea monotherapy in chronic myeloid leukemia (CML-Study II): prolongation of survival by the combination of interferon alpha and hydroxyurea. Leukemia 17:1529–1537

    Article  PubMed  CAS  Google Scholar 

  • Hehlmann R, Heimpel H, Hasford J, Kolb HJ, Pralle H, Hossfeld DK, Queißer W, Löffler H, Hochhaus A, Heinze B, Georgii A, Bartram CR, Grießhammer M, Bergmann L, Essers U, Falge C, Queißer U, Meyer P, Schmitz N, Eimermacher H, Walther F, Fett W, Kleeberg UR, Käbisch A, Nerl C, Zimmermann R, Meuret G, Tichelli A, Kanz L, Tigges F-J, Schmid L, Brockhaus W, Tobler A, Reiter A, Perker M, Emmerich B, Verpoort K, Zankovich R v. Wussow P, Prümmer O, Thiele J, Buhr T, Ansari H, German CML Study Group (1994) Randomized comparison of interferon-alpha with busulfan and hydroxyurea in chronic myelogenous leukemia. Blood 84:4064–4077

    PubMed  CAS  Google Scholar 

  • Hensley ML, van Hoomissen IC, Krahnke T, Gathmann I, Thomas E, Ben-Am M, Koehler J, Zoellner U, Schneider A, Capdeville R (2003) Imatinib in chronic myeloid leukemia (CML): outcomes in >7000 patients treated on expanded access program (EAP). Proc Am Soc Clin Oncol 22:579

    Google Scholar 

  • Hochhaus A, Fischer T, Brümmendorf TH, Schoch C, Müller MC, Merx K, Bostel T, Berger U, Rose MT, Gschaidmeier H, Hehlmann R (2002) Imatinib (Glivec) and pegylated interferon a2a (Pegasys) phase I/II combination study in chronic phase chronic myelogenous leukemia (CML). Blood 1:164a–165a

    Google Scholar 

  • Hochhaus A, La Rosée P ((2004) Imatinib therapy in chronic myelogenous leukemia: strategies to avoid and overcome resistance. Leukemia 18:1321–1331

    Article  PubMed  CAS  Google Scholar 

  • Hughes T, Branford S, Reynolds J, Seymour J, Taylor K, Guzzo-Pernell N, Filshie R, Arthur C, Schwarer A, Hertzberg M, Rudzki Z, Copeman M, Lynch K, Grigg A (2004) Higher-dose imatinib (600 mg/day) with selective intensification in newly diagnosed CML patients in chronic phase: cytogenetic response rates at 12 months are superior to IRIS. Blood 1:286a

    Google Scholar 

  • Hughes TP, Kaeda J, Branford S, Rudzki Z, Hochhaus A, Hensley ML (2003) Frequency of major molecular responses to imatinib or interferon alfa plus cytarabine in newly diagnosed chronic myeloid leukemia. N Engl J Med 349:1423–1432

    Article  PubMed  CAS  Google Scholar 

  • Kantarjian H, Sawyers C, Hochhaus A, Guilhot F, Schiffer C, Gambacorti-Passerini C, Niederwieser D, Stone R, Goldman J, Fischer T, Cony-Makhoul P, Miller C, Tallman M, O’Brien S, Brown R, Schuster M, Gratwohl A, Loughran T, Mandelli F, Saglio G, Ottmann O, Lazzarino M, Tura S, Baccarani M, Facon T, Morra E, Russell N, Zoellner U, Resta D, Capdeville R, Talpaz M, Druker B (2002) Hematologic and cytogenetic responses to imatinib mesylate in chronic myelogenous leukemia. N Engl J Med 346:645–652

    Article  PubMed  CAS  Google Scholar 

  • Kantarjian HM, O’Brien S, Cortes J, Giles FJ, Rios MB, Shan J, Faderl S, Garcia-Manero G, Ferrajoli A, Verstovsek S, Wierda W, Keating M, Talpaz M (2003) Imatinib mesylate therapy improves survival in patients with newly diagnosed Philadelphia chromosome-positive chronic myelogenous leukemia in the chronic phase: comparison with historic data. Cancer 98:2636–2642

    Article  PubMed  CAS  Google Scholar 

  • Kantarjian H, Talpaz M, O’Brien S, Gracia-Manero G, Verstovsek S, Giles F (2004) High-dose imatinib mesylate therapy in newly diagnosed Philadelphia chromosome-positive chronic phase chronic myeloid leukemia. Blood 103:2873–2878

    Article  PubMed  CAS  Google Scholar 

  • Kantarjian H, Giles F, Wunderle L, Bhalla K, O’Brien S, Wassmann B, Tanaka C, Manley P, Rae P, Mietlowski W, Bochinski K, Hochhaus A, Griffin JD, Hoelzer D, Albitar M, Dugan M, Cortes J, Alland L, Ottmann OG (2006) Nilotinib in imatinib-resistant CML and Philadelphia chromosome-positive ALL. N Engl J Med 354:2542–2551

    Article  PubMed  Google Scholar 

  • Lahaye T, Riehm B, Berger U, Paschka P, Müller MC, Kreil S, Merx K, Schwindel U, Schoch C, Hehlmann R, Hochhaus A (2005) Response and resistance in 300 patients with BCR-ABL-positive leukemias treated with imatinib in a single center: a 4.5-year follow-up. Cancer 103:1659–1669

    Article  PubMed  Google Scholar 

  • Ly Chi, Arechiga A, Melo JV et al (2003) Bcr-Abl kinase modulates the translation regulators ribosomal protein S6 and 4E-BP1 in chronic myelogenous leukemia cells via the mammalian target of rapamycin. Cancer Res 63:5716–5722

    PubMed  CAS  Google Scholar 

  • Marin D, Marktel S, Bua M, Szydlo RM, Franceschino A, Nathan I, Foot N, Crawley C, Nakorn T, Olavarria E, Lennard A, Neylon A, O’Brien SG, Goldman JM, Apperley JF (2003) Prognostic factors for patients with chronic myeloid leukaemia in chronic phase treated with imatinib mesylate after failure of interferon alfa. Leukemia 17:1448–1453

    Article  PubMed  CAS  Google Scholar 

  • O’Brien S, Guilhot F, Larson R, Gathmann I, Baccarani M, Cervantes F, Cornelissen JJ, Fischer T, Hochhaus A, Hughes T, Lechner K, Nielsen JL, Rousselot P, Reiffers J, Saglio G, Shepherd J, Simonsson B, Gratwohl A, Goldman JM, Kantarjian H, Taylor K, Verhoef G, Bolton AE, Capdeville R, Druker BJ for the IRIS Investigators (2003) The IRIS study: international randomized study of interferon and low-dose ara-C versus STI571 (imatinib) in patients with newly-diagnosed chronic phase chronic myeloid leukemia. N Engl J Med 348:994–1004

    Article  PubMed  CAS  Google Scholar 

  • Peters DG, Hoover RR, Gerlach MJ et al (2001) Activity of the farnesyl protein transferase inhibitor SCH66336 against BCR/ABL-induced murine leukemia and primary cells from patients with chronic myeloid leukemia. Blood 97:1404–1412

    Article  PubMed  CAS  Google Scholar 

  • Sawyers CL, Hochhaus A, Feldman E, Goldman JM, Miller C, Ottmann OG, Schiffer CA, Talpaz M, Guilhot F, Deininger MWN, Fischer T, O’Brien SG, Stone R, Gambacorti-Passerini C, Russell N, Reiffers J, Shea T, Chapuis B, Coutre S, Tura S, Morra E, Larson RA, Saven A, Peschel C, Gratwohl A, Mandelli F, Ben-Am M, Gathmann I, Capdeville R, Paquette RL, Druker BJ (2002) Gleevec/Glivec (imatinib mesylate) induces hematologic and cytogenetic responses in patients with chronic myeloid leukemia in myeloid blast crisis: results of a phase II study. Blood 99:3530–3539

    Article  PubMed  CAS  Google Scholar 

  • Shah NP, Tran C, Lee FY, Chen P, Norris D, Sawyers CL (2004) Overriding imatinib resistance with a novel ABL kinase inhibitor. Science 305:399–401

    Article  PubMed  CAS  Google Scholar 

  • Silver RT, Talpaz M, Sawyers CL, Druker BJ, Hochhaus A, Schiffer CA, Guilhot F, Goldman JM, Smith BD, Mone M, Krahnke T, Kantarjian HM (2004) Four years of follow-up of 1027 patients with late chronic phase (L-CP), accelerated phase (AP), or blast crisis (BC) chronic myeloid leukemia (CML) treated with imatinib in three large phase ii trials. Blood 104Suppl 1:11a

    Google Scholar 

  • Soverini S, Martinelli G, Rosti G, Bassi S, Amabile M, Poerio A, Giannini B, Trabacchi E, Castagnetti F, Testoni N, Luatti S, de Vivo A, Cilloni D, Izzo B, Fava M, Abruzzese E, Alberti D, Pane F, Saglio G, Baccarani M (2005) 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 23:4100–4109

    Article  PubMed  CAS  Google Scholar 

  • Talpaz M, Silver RT, Druker BJ, Goldman JM, Gambacorti-Passerini C, Guilhot F, Schiffer CA, Deininger MWN, Lennard AL, Hochhaus A, Ottmann OG, Gratwohl A, Baccarani M, Stone R, Tura S, Mahon FX, Fernandes-Reese S, Gathmann I, Capdeville R, Kantarjian HM, Sawyers CL (2002) Imatinib induces durable hematologic and cytogenetic responses in patients with accelerated phase chronic myeloid leukemia: results of a phase 2 study. Blood 99:1928–1937

    Article  PubMed  CAS  Google Scholar 

  • Weisberg E, Manley PW, Breitenstein W, Bruggen J, Cowan-Jacob SW, Ray A, Huntly B, Fabbro D, Fendrich G, Hall-Meyers E, Kung AL, Mestan J, Daley GQ, Callahan L, Catley L, Cavazza C, Azam M, Neuberg D, Wright RD, Gilliland DG, Griffin JD (2005) Characterization of AMN107, a selective inhibitor of native and mutant Bcr-Abl. Cancer Cell 7:129–141

    Article  PubMed  CAS  Google Scholar 

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Hochhaus, A. (2007). Treatment with Tyrosine Kinase Inhibitors. In: Myeloproliferative Disorders. Hematologic Malignancies. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-34506-0_6

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  • DOI: https://doi.org/10.1007/978-3-540-34506-0_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-34505-3

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