Current and emerging treatment options in chronic myeloid leukemia

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Abstract
Treatments for chronic myeloid leukemia (CML) represent a success story in molecular medicine. The development of imatinib, a tyrosine kinase inhibitor (TKI) targeted against the causative Bcr‐Abl oncoprotein in CML, has resulted in hematologic and cytogenetic remissions in all phases of CML. A significant proportion of patients are resistant to imatinib or develop resistance during treatment. This is often a result of mutated forms of the Bcr‐Abl oncoprotein to which imatinib is unable to bind. Several strategies have been developed to overcome the problem of imatinib resistance, including high‐dose imatinib, novel targeted agents, and combination treatments. Novel agents include dasatinib, a potent TKI that inhibits several critical oncogenic proteins and which has recently been approved for patients with CML who are resistant or intolerant to imatinib; and nilotinib, a potent selective Bcr‐Abl kinase inhibitor currently in clinical development. Other agents in development include SKI‐606 and INNO‐406. Stem cell transplantation remains a useful option, although it is not generally used as first‐line treatment. Overall, there are an increasing number of treatment options available for patients with CML. Cancer 2007. © 2007 American Cancer Society.

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