Development and targeted use of nilotinib in chronic myeloid leukemia

Carmen Fava, Hagop Kantarjian, Jorge Cortes, Elias Jabbour

Research output: Contribution to journalReview article

16 Scopus citations

Abstract

The development of imatinib has resulted in sustained hematologic and cytogenetic remissions in all phases of chronic myeloid leukemia (CML). Despite the high efficacy, relapses have been observed and are much more prevalent in patients with advanced disease. The most common mechanism of acquired resistance has been traced to Bcr-Abl kinase domain mutations. Several strategies have been developed to overcome the problem of imatinib resistance, including imatinib dose escalation, novel targeted agents and combination treatments. A second generation of tyrosine kinase inhibitors was developed, which displays increased potency towards Bcr-Abl and is able to target the majority of CML mutant clones. Nilotinib (Tasigna®, AMN107, Novartis) is a close analog of imatinib with approximately 20-fold higher potency for BCR-ABL kinase inhibition. Preclinical and clinical investigations demonstrate that nilotinib effectively overcomes imatinib resistance, and has induced high rates of hematologic and cytogenetic responses in CML post imatinib failure, with a good tolerance. Nilotinib has been approved for CML patients in chronic and accelerated phases, post imatinib failure.

Original languageEnglish (US)
Pages (from-to)233-243
Number of pages11
JournalDrug Design, Development and Therapy
Issue number2
StatePublished - Dec 1 2008
Externally publishedYes

Keywords

  • CML
  • Imatinib-intolerance
  • Imatinib-resistance
  • Nilotinib

ASJC Scopus subject areas

  • Pharmacology
  • Pharmaceutical Science
  • Drug Discovery

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