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Narrative Review | Oncology Science | India | Volume 13 Issue 9, September 2024 | Rating: 4.9 / 10
Effects of Tyrosine Kinase Inhibitors on Chronic Myeloid Leukemia Patients: A Narrative Review
Dr. Tapan Giri
Abstract: Tyrosine kinase inhibitors (TKI) are a type of targeted therapy which have already shown growing evidence in the treatment of chronic myeloid leukaemia patients. This is a comprehensive review of the effects of tyrosine kinase inhibitors on chronic myeloid leukaemia patients. The natural course of CML has been greatly modified by TKIs, which have dramatically transformed patient survival. Second-generation tyrosine kinase inhibitors used in first-line therapy led to more rapid and profound molecular remission with different adverse event profiles as compared to imatinib (1st generation). There has been a lot of research on the medical effects of tyrosine kinase inhibitors and their mechanism of action. However, even though they are extremely effective, there have been incidences of resistance to tyrosine kinase inhibitors. There have been higher cases of patients not responding to TKIs (Primary resistance) or relapse after treatment (Secondary resistance). One of the most common tyrosine kinase inhibitors is Imatinib. It blocks the BCR-ABL fusion protein. There are three second-generation agents (nilotinib, dasatinib, bosutinib) that are more effective than Imatinib, but they have not shown long-lasting effects. Asciminib is used if the initial 1st line therapy fails. BCR-ABL mutational analysis is important and has to be done for the treatment of CML if the initial therapy fails. Single point mutations of BCR-ABL are the most common cause of Imatinib resistance. Conventional Sanger sequencing is done to check for these mutations, but Next-generation sequencing is the newest modality to test for them.
Keywords: CML, Tyrosine kinase inhibtors, Chronic Myeloid Leukemia, Elderly, Chronic Granulocytic Leukemia
Edition: Volume 13 Issue 9, September 2024,
Pages: 330 - 333