Glivec Is the Standard of Care for CML in All Stages
Glivec® (imatinib) is the first protein-tyrosine kinase inhibitor, a class of rationally designed drugs that target oncogenic events with unprecedented specificity12, 63, 64. The treatment algorithm shown in Figure 1 demonstrates the use of Glivec as the cornerstone therapy for patients with chronic myeloid leukaemia (CML). Stem-cell transplantation (SCT) can be considered as a further option in appropriate cases63. Glivec is the preferred pharmacotherapeutic treatment option for patients with CML at all disease stages, with efficacy superior to previous systemic therapies, and has been demonstrated to be well tolerated in all studies8,12,35,63. Glivec is the standard of care for CML in all stages65.
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Figure 1. Algorithm for treating chronic myeloid leukemia63.
Other Therapeutic Approaches for Treatment of CML
Several other approaches to the treatment of CML are also under investigation. These include new transplant strategies and novel agents. Many of these are entering clinical trials, and some have shown encouraging activity. These new strategies include:
- Inhibition of gene expression
- Immunomodulation
- Novel tyrosine kinase inhibitors (TKIs)
- Recently approved dasatinib
- Others in development, including nilotinib (AMN107)
Other agents under investigation for the treatment of CML include:
- Polyethylene glycol interferon alfa (IFN-α; PEG interferon)
- Decitabine
- Homoharringtonine (HHT)
Other transplantation approaches under investigation for the treatment of CML include:
- Autologous SCT
- Reduced intensity conditioning SCT
The precise role of these additional therapeutic options in the management of CML is yet to be defined.
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