Patients with newly diagnosed chronic myeloid leukemia (CML) treated in the front-line setting with the tyrosine kinase inhibitor (TKI) dasatinib experience better health-related quality of life (HRQOL) than do patients treated with the TKI imatinib, though this difference becomes less apparent in patients aged 60 years or older, according to results from a study published in Leukemia.

Researchers wanted to elucidate the HRQOL outcomes of front-line therapy with 1 of 2 TKIs in CML due to a general lack of available evidence. Imatinib is the first-generation TKI for the treatment of CML. The newer TKIs elicit higher and faster molecular and cytogenetic responses than imatinib, but no differences have been shown in clinical outcomes such as overall survival. Elucidating differences in TKIs with regards to HRQOL could help differentiate one TKI from another.

This multicenter, propensity-matched, case-control study compared HRQOL in 323 patients with newly diagnosed CML who received first-line treatment in the case arm with dasatinib (100 patients) or in the control arm with imatinib (223 patients).

The EORTC QLQ-C30 and EORTC QLQ-CML24 questionnaires were used to determine patient-reported HRQOL, with the scale for impact on daily life in the EORTC QLQ-CML24 selected beforehand as the principal HRQOL scale for the comparison.

Patients who received dasatinib reported superior disease-specific HRQOL outcomes in impact on daily life (Δ = 8.72; 95% CI, 3.17-14.27; P =.002), satisfaction with social life (Δ = 13.45; 95% CI, 5.82-21.08; P =.001), and symptom burden (Δ = 7.69; 95% CI, 3.42-11.96; P =.001).

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Results from age-group analysis indicated that patients aged 60 years and older experienced smaller differences favoring dasatinib across multiple disease-specific and cancer-generic domains in HRQOL.

“Our HRQOL results extend current knowledge on safety and efficacy data of dasatinib imatinib and can help both patients and physicians to make more informed treatment decisions,” concluded the authors.

Reference

1. Efficace F, Stagno F, Iurlo A, et al. Health-related quality of life of newly diagnosed chronic myeloid leukemia patients treated with first-line dasatinib versus imatinib therapy [published September 2, 2019]. Leukemia. doi:10.1038/s41375-019-0563-0