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Imatinib: Clinical Pharmacology and Therapeutic Results

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Chemotherapy for Leukemia

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Abstract

Imatinib has a remarkable long-term efficacy in patients with chronic myelogenous leukemia (CML) in the chronic phase. Reported rates of 5-year progression-free survival and overall survival associated with imatinib therapy (400 mg daily) have ranged between 83–94% and 83–97%, respectively. Imatinib is generally well tolerated, and adverse events are typically manageable. Current evidence does not support the extensive use of high-dose imatinib (800 mg daily) as a frontline treatment in patients with CML, and also the excessive dose reductions to less than 300 mg imatinib should be avoided, even in patients who are intolerant to 400 mg imatinib. Addition of pegylated interferon α to imatinib offers additional benefits for CML treatment; however, its addition does not appear to improve PFS or OS. The early molecular response (BCR-ABL1 transcript level of ≤10% at 3 months) is reportedly associated with improved prognosis in several studies. Furthermore, approximately 40% of patients who exhibited sustained deep molecular response could maintain treatment-free remission after discontinuation of imatinib. Treatment-free remission is now considered to be a new goal of tyrosine kinase inhibitor therapy in patients with CML in the chronic phase.

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  1. Japanese Red Cross Aichi Blood Center, 539-3 Minamiyamaguchi-cho, Seto, Aichi, 489-8555, Japan

    Kazunori Ohnishi

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  1. University of Fukui, Fukui, Japan

    Takanori Ueda

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Ohnishi, K. (2017). Imatinib: Clinical Pharmacology and Therapeutic Results. In: Ueda, T. (eds) Chemotherapy for Leukemia. Springer, Singapore. https://doi.org/10.1007/978-981-10-3332-2_3

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