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Imatinib and Beyond—Therapy of CML in 2008

From the Department of Leukemia, University of Texas M. D. Anderson Cancer Center, Houston, Texas

Author's disclosure of potential conflicts of interest is found at the end of this article.

Address reprint requests to Jorge E. Cortes, MD, Department of Leukemia, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 428, Houston, TX 77030; e-mail: jcortes{at}mdanderson.org

Overview: Imatinib mesylate has revolutionized the therapy of newly diagnosed patients with chronic myeloid leukemia (CML). The results with imatinib continue to be excellent for most patients after more than 6 years of use in the frontline setting. Still, with increased use, new questions arise related to the optimal treatment of patients. For those patients who do not achieve an optimal response to imatinib or for those patients who lose their response or become intolerant, new treatment options have emerged that have demonstrated significant efficacy with a good toxicity profile, including two recently approved agents (dasatinib and nilotinib) and other investigational agents with encouraging results (bosutinib, INNO-406). With increased availability of treatment options, proper patient monitoring and treatment as well as optimal use of the different options become critical to optimize patient outcome.