Nilotinib-associated vascular events

Alfonso Quintás-Cardama, Hagop Kantarjian, Jorge Cortes

Research output: Contribution to journalArticle

88 Scopus citations

Abstract

Nilotinib is a highly selective inhibitor of the inactive conformation of ABL1 kinase. An improved topologic fit to the ABL1 protein-binding surface contributes to its increased potency over imatinib. This higher selectivity in vitro translated to an improved tolerability in vivo. In fact, nilotinib therapy in the frontline phase III ENESTnd (Evaluating Nilotinib Efficacy and Safety in Clinical Trials-Newly Diagnosed Patients) study was associated with an improved toxicity profile compared with that of imatinib. Intriguingly, several cases of severe peripheral artery occlusive disease (PAOD) have been reported among patients treated with nilotinib in small series. We have identified 5 patients with chronic myeloid leukemia (CML) in whom vascular events developed that were likely related to nilotinib therapy among 233 (2%) patients treated at our institution: 1 patient had recurrent Raynaud syndrome, a second patient had recurrent cerebrovascular accidents, and 3 other patients had PAOD (2 of them with other vascular events, including coronary artery disease and pulmonary emboli, respectively). Risk factors for vascular disease were present in only 1 patient with a history of diabetes mellitus. Although the incidence of vascular events is low, this potential complication should be taken into account when selecting nilotinib for the treatment of CML.

Original languageEnglish (US)
Pages (from-to)337-340
Number of pages4
JournalClinical Lymphoma, Myeloma and Leukemia
Volume12
Issue number5
DOIs
StatePublished - Oct 1 2012
Externally publishedYes

Keywords

  • BCR-ABL1
  • Chronic myeloid leukemia
  • Nilotinib
  • Vascular events

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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