Imatinib versus Dasatinib in Newly Diagnosed Chronic-Phase CML: Quality-of-Life Assessment in the NCRI SPIRIT2 Study

Conference Correspondent - ASH 2015 - Leukemia

The tyrosine kinase inhibitors imatinib and dasatinib are used extensively as first-line therapy in patients with chronic myeloid leukemia (CML); however, there has been no direct comparison of quality of life (QoL) with these 2 agents in this setting. The SPIRIT2 (STI571 Prospective International Randomised Trial 2) trial previously showed that first-line dasatinib (100 mg once daily) has a superior complete cytogenetic response and major molecular response rate compared with imatinib (400 mg once daily); it also incorporated generic and cancer-specific QoL assessment as a secondary end point of the trial, the results of which were presented by Labeit and colleagues.1

QoL was assessed at baseline, at 1, 2, 3, 6, and 12 months after trial entry, and thereafter annually using the EQ-5D, FACT-G, FACT-BRM, and the FACT-TOI QoL measures. No significant differences in QoL were found between imatinib and dasatinib in both generic and cancer-specific instruments. For dasatinib, the EQ-5D score was 0.77 and 0.80 at baseline and at 1 year, respectively, and was 0.79 and 0.82 for imatinib (2-3 basis points), respectively. The FACT-G, FACT-BRM, and the FACT-TOI assessments also showed the same results. There was a slight increase for the FACT-G (4-5 basis points), FACT-TOI (3-4 basis points), and FACT-BRM (8-10 basis points) after 1 year for both treatments, but this difference was not significant. No changes in emotional and functional well-being scores were as observed between the 2 treatment arms. Moreover, in an exploratory analysis, the development of pleural effusion also did not have a large effect on QoL. These results suggest that, despite different side effect profiles, there are no significant differences in QoL between standard-dose imatinib and dasatinib over time.

  1. Labeit AM, et al. ASH 2015. Abstract 4024.