Third-line therapy for chronic myeloid leukemia: current status and future directions

Table 2 Responses seen in studies of 3L therapy

3L study	Efficacy
A retrospective study of patients receiving 2L dasatinib or nilotinib after imatinib [55]	Significant correlation between higher rates of CCyR and DMR and no treatment interruption with ≤ 2L 5-year OS was 83.0% in total and 94.5% in patients with CML-CP
A report of patients treated with 3 sequential TKIs [27]	Best response to 3L 2GTKI in 48 patients was MMR in 5 patients, CCyR in 3 patients, partial or minor CyR in 5 patients, and CHR in 6 patients
A report of patients treated with dasatinib or nilotinib after failing imatinib [57]	Rates of MCyR, CCyR, and MMR were 50.0%, 34.6%, and 19.2%, respectively
A study of patients receiving 3L nilotinib or dasatinib [58]	CHR, MCyR, CyR, CCyR, and MMR rates were 31.7%, 7.3%, 14.6%, 17.1%, and 15.9%, respectively, with 14.6% having no response Overall, 14% of patients died
A retrospective study of patients on 3L [52]	MCyR and CCyR were achieved in 15 of 45 and 11 of 52 patients, respectively Overall, 13 patients died
A single-center study of nilotinib or dasatinib in patients who failed 2 prior TKIs [59]	CHR, CCyR, and MMR were achieved in 89%, 13%, and 24%, respectively, of patients with CML-CP Of patients with CHR, 56% lost that response within a median of 23 months 5-year OS, PFS, and EFS were 86%, 54%, and 22%, respectively

2GTKI second-generation tyrosine kinase inhibitor, 2L second line, 3L third line, CCyR complete cytogenetic response, CHR complete hematologic response, CML-CP chronic myeloid leukemia in chronic phase, CyR cytogenetic response, DMR deep molecular response, EFS event-free survival, MCyR major cytogenetic response, MMR major molecular response, OS overall survival, PFS progression-free survival, TKI tyrosine kinase inhibitor

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