Efficacy and Safety of Generic Dasatinib in Patients With Newly Diagnosed Chronic Myeloid Leukemia in Chronic Phase: A Multicenter Prospective Study in China

Clin Lymphoma Myeloma Leuk. 2022 Sep;22(9):e867-e873. doi: 10.1016/j.clml.2022.05.002. Epub 2022 May 21.

Abstract

Background: Brand-name dasatinib was approved for newly diagnosed chronic myeloid leukemia-chronic phase (CML-CP) patients due to its deeper and faster molecular response than imatinib. Generics, as the alternative, low-cost forms, are much in demand. This study aimed to evaluate the efficacy and safety of generic dasatinib (Yinishu) as a first-line treatment in CML-CP.

Materials and methods: This was a prospective, multicenter, single-arm study from May 2016 to October 2018 with a 2-year follow-up analysis. All patients were given 100 mg/d (initial dose) of the generic dasatinib once a day. The primary endpoint was the major molecular response (MMR) calculated based on the BCR-ABL1 gene mutation rate of ≤ .1% at 12 months.

Results: Among 55 patients in CP observed for at least 3 months, 80.4% achieved MMR at 12 months. The cumulative MR4.5 was 58.2% by 24 months. Responses occurred rapidly, with 69.1% of patients achieving complete cytogenetic response (CCyR) by 3 months and 70.9% achieving CCyR by 6 months. The estimated 2-year PFS and OS were both 96%, with a median follow-up time of 24 months. Grade 3 neutropenia occurred in 8.5% of patients, and thrombocytopenia occurred in 11.9% of patients. Nonhematologic toxicity was usually mild and manageable. Pleural effusion occurred in 20.3% of patients, and only 1 patient (1.7%) had a grade 3 pleural effusion. No grade 4 adverse events were observed.

Conclusion: Generic dasatinib is an effective option for newly diagnosed CML-CP patients, producing an MMR early in a greater number of patients during their therapy.

Keywords: Clinical trial; Complete cytogenetic response; Generic dasatinib (Yinishu); Molecular major response; Protein Kinase Inhibitors.

Publication types

  • Multicenter Study

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Dasatinib / adverse effects
  • Drugs, Generic / adverse effects
  • Humans
  • Imatinib Mesylate / therapeutic use
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / drug therapy
  • Leukemia, Myeloid, Chronic-Phase* / drug therapy
  • Leukemia, Myeloid, Chronic-Phase* / genetics
  • Pleural Effusion*
  • Prospective Studies
  • Protein Kinase Inhibitors / adverse effects
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Drugs, Generic
  • Protein Kinase Inhibitors
  • Imatinib Mesylate
  • Dasatinib