King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
The University of Texas MD Anderson Cancer Center, LEUKEMIA, Houston, TX, USA.
Leuk Lymphoma. 2020 Apr;61(4):776-787. doi: 10.1080/10428194.2019.1691196. Epub 2019 Nov 18.
The treatment landscape of chronic myeloid leukemia (CML) was radically changed with the introduction of imatinib in 2001. With the emergence of treatment failure with imatinib, more specific and potent second- and third-generation tyrosine kinase inhibitors (TKIs) were developed. Currently, 6 TKIs and one protein synthesis inhibitor are available on the market for CML treatment. Despite the availability of these agents, it is not uncommon for some patients to experience treatment failure across several lines of therapy. Sequencing the available treatment options is a challenging task that becomes more complex after patients fail the more potent second- and third-generation TKIs. The ability to successfully salvage such patients is limited. In this paper, we will briefly review the mechanisms of treatment failure in chronic-phase CML (CP-CML) and focus on the complexity of managing patients who fail a second-generation TKI.
2001 年伊马替尼的问世彻底改变了慢性髓性白血病（CML）的治疗格局。随着伊马替尼治疗失败的出现，开发出了更特异和更强效的第二代和第三代酪氨酸激酶抑制剂（TKI）。目前，有 6 种 TKI 和 1 种蛋白合成抑制剂可用于 CML 的治疗。尽管有这些药物可用，但一些患者在经过多线治疗后仍出现治疗失败并不罕见。对现有治疗方案进行排序是一项具有挑战性的任务，在患者对更有效力的第二代和第三代 TKI 治疗失败后，这项任务变得更加复杂。成功挽救此类患者的能力有限。在本文中，我们将简要回顾慢性期 CML（CP-CML）治疗失败的机制，并重点讨论管理第二代 TKI 治疗失败患者的复杂性。
