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Systemic Anti-Cancer Therapy Regimen Library

LEU CML - imatinib

Treatment Overview

imatinib 400 mg daily: Chronic phase CML.

imatinib 600 mg daily: Accelerated or blast phase CML.

Give continuously until disease progression or unacceptable toxicity.

Supportive Care Factors

Factor Value
Emetogenicity: Minimal to low
Tumour lysis syndrome prophylaxis: Tumour lysis syndrome prophylaxis may be considered

Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines.

References

Hughes, T. P., S. Branford, D. L. White, et al. 2008. "Impact of early dose intensity on cytogenetic and molecular responses in chronic- phase CML patients receiving 600 mg/day of imatinib as initial therapy." Blood 112(10):3965-3973. , PMID: 18768781

Yeung, D. T., M. P. Osborn, D. L. White, et al. 2015. "TIDEL-II: first-line use of imatinib in CML with early switch to nilotinib for failure to achieve time-dependent molecular targets." Blood 125(6):915-923., PMID: 25519749

Hehlmann, R., M. Lauseker, S. Jung-Munkwitz, et al. 2011. "Tolerability-adapted imatinib 800 mg/d versus 400 mg/d versus 400 mg/d plus interferon-alpha in newly diagnosed chronic myeloid leukemia." J Clin Oncol 29(12):1634-1642., PMID: 21422420

Cortes, J. E., M. Baccarani, F. Guilhot, et al. 2010. "Phase III, randomized, open-label study of daily imatinib mesylate 400 mg versus 800 mg in patients with newly diagnosed, previously untreated chronic myeloid leukemia in chronic phase using molecular end points: tyrosine kinase inhibitor optimization and selectivity study." J Clin Oncol 28(3):424-430., PMID: 20008622

Deininger, M. W., K. J. Kopecky, J. P. Radich, et al. 2014. "Imatinib 800 mg daily induces deeper molecular responses than imatinib 400 mg daily: results of SWOG S0325, an intergroup randomized PHASE II trial in newly diagnosed chronic phase chronic myeloid leukaemia." Br J Haematol 164(2):223-232. , PMID: 24383843

Baccarani, M., M. W. Deininger, G. Rosti, et al. 2013. "European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013." Blood 122(6):872-884. , PMID: 23803709

Druker BJ, Guilhot F, O'Brien SG et al. 2006. " Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia". N Engl J Med. 2006;355(23):2408- 2417. , PMID: 17151364

Hochhaus, A., R. A. Larson, F. Guilhot, et al. 2017. "Long-Term Outcomes of Imatinib Treatment for Chronic Myeloid Leukemia." N Engl J Med 376(10):917-927. , PMID: 28273028

Rea, D., G. Etienne, F. Nicolini, et al. 2012. "First-line imatinib mesylate in patients with newly diagnosed accelerated phase-chronic myeloid leukemia." Leukemia 26(10):2254-2259. , PMID: 22460758

Palandri, F., F. Castagnetti, N. Testoni, et al. 2008. "Chronic myeloid leukemia in blast crisis treated with imatinib 600 mg: outcome of the patients alive after a 6-year follow-up." Haematologica 93(12):1792-1796., PMID: 18838477

Kantarjian H, Shah NP, Hochhaus A. et al. 2010 " Dasatinib versus imatinib in newly diagnosed chronic-phase chronic myeloid leukemia". N Engl J Med. Jun 17;362(24):2260-70. , PMID: 20525995

Saglio G, Kim DW, Issaragrisil S et al. 2010 " Nilotinib versus imatinib for newly diagnosed chronic myeloid leukemia". N Engl J Med. Jun 17;362(24):2251-2259., PMID: 20525993

Rex Medical Limited Imatinib New Zealand Datasheet 17 May 2018 https://www.medsafe.govt.nz/profs/datasheet/i/imatinibcap.pdf (Accessed 29 March 2022).

Emetogenicity rating – personal communication to J.Wilson from Dr R Weinkove 18 May 2022.

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.