University of Milan-Bicocca, Monza, Italy
Carlo Gambacorti-Passerini , Tim H. Brummendorf , Jorge E. Cortes , Jeffrey H. Lipton , Dong-Wook Kim , Eric Leip , Kathleen Wyant Turnbull , Hagop M. Kantarjian , Hanna Jean Khoury
Background: BOS is an oral dual Src/Abl tyrosine kinase inhibitor (TKI) approved for treatment of Ph+ CML following resistance/intolerance to prior therapy. Prior reports from this phase I/II trial indicated the BOS safety profile was primarily characterized by myelosuppression, gastrointestinal events, and rash. The current analysis compares the incidence of toxicity in Year 1 (Y1) for pts on treatment ≤1 y and within Y1 and Year 2 (Y2) for pts on treatment for >1 y. Methods: BOS 500 mg/d was evaluated in 3 cohorts: chronic phase (CP) CML after imatinib only (CP 2L cohort; n = 286); CP CML after imatinib + dasatinib and/or nilotinib (CP 3L cohort; n = 119); and accelerated/blast phase CML or ALL after prior TKI therapy (ADV cohort; n = 164). Results: The most common treatment-emergent adverse events (TEAEs) in each cohort occurred more frequently within Y1 than Y2 (Table). The incidence for grade 3/4 events followed a similar pattern. AEs were the most common reason for BOS discontinuation in Y1 (CP 2L, 53%; CP 3L, 32%; ADV, 41%). Of the pts whose primary reason for discontinuing BOS was an AE during the first 2 y, most did so during Y1 (CP 2L, n = 51/60 [85%]; CP 3L, n = 22/24 [92%]; ADV, n = 24/25 [96%]); the most common reasons during Y1 were thrombocytopenia (12%; 9%; 4%), increased ALT (6%; 4%; 2%), neutropenia (3%; 6%; 0%), diarrhea (4%; 3%; 0%), and vomiting (3%; 4%; 1%). Serious AEs were more common among pts who discontinued BOS ≤1 y versus on treatment >1 y in the CP 3L and ADV cohorts, but similar in the CP 2L cohort (Table). Conclusions: Discontinuation due to AEs was observed primarily in Y1. For pts on BOS for >1 y, the incidence of common TEAEs decreased substantially after Y1, suggesting BOS tolerability improves after long-term exposure. Clinical trial information: NCT00261846.
CP 2L |
CP 3L |
ADV |
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---|---|---|---|---|---|---|---|---|---|
BOS ≤1 y (n = 97) |
BOS >1 y (n = 189) |
BOS ≤1 y (n = 69) |
BOS >1 y (n = 50) |
BOS ≤1 y (n = 125) |
BOS >1 y (n = 40) |
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Y1 | Y1 | Y2 | Y1 | Y1 | Y2 | Y1 | Y1 | Y2 | |
TEAE, % | |||||||||
Diarrhea | 90 | 81 | 40 | 83 | 82 | 50 | 69 | 90 | 28 |
Nausea | 41 | 45 | 12 | 51 | 36 | 18 | 42 | 58 | 15 |
Vomiting | 40 | 31 | 7 | 41 | 32 | 8 | 41 | 43 | 8 |
Thrombocytopenia | 34 | 28 | 19 | 28 | 36 | 20 | 34 | 30 | 18 |
Rash | 29 | 33 | 12 | 23 | 24 | 12 | 22 | 53 | 13 |
Abdominal pain | 24 | 21 | 8 | 19 | 16 | 14 | 16 | 30 | 8 |
Fatigue | 23 | 19 | 10 | 25 | 16 | 14 | 19 | 10 | 10 |
Increased ALT | 23 | 19 | 7 | 12 | 18 | 6 | 9 | 13 | 5 |
Anemia | 22 | 14 | 13 | 15 | 12 | 8 | 36 | 35 | 18 |
Pyrexia | 21 | 18 | 10 | 15 | 12 | 8 | 40 | 20 | 18 |
Headache | 16 | 12 | 9 | 29 | 20 | 6 | 18 | 20 | 8 |
Serious AE, % | 25 | 25 | 23 | 30 | 20 | 18 | 60 | 33 | 33 |
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Abstract Disclosures
2018 ASCO Annual Meeting
First Author: Carlo Gambacorti-Passerini
2023 ASCO Annual Meeting
First Author: Angela Awino MCLIGEYO
2024 ASCO Annual Meeting
First Author: Timothy P. Hughes
2015 ASCO Annual Meeting
First Author: Chatree Chai-Adisaksopha