Researchers have announced that, for patients with acute lymphoblastic leukaemia (ALL) driven by the Philadelphia chromosome, the drug dasatinib provides more benefit than the standard-of-care drug imatinib.
US and Chinese researchers worked together on the first trial of its kind. In the randomised phase III clinical trial, researchers from St Jude Children’s Research Hospital in Memphis, USA, and the Chinese Children’s Cancer Group compared imatinib, the first targeted therapy for Philadelphia chromosome-positive (Ph+) ALL, and dasatinib, a next-generation inhibitor.
They found that the dasatinib led to an event-free survival rate of 71% compared to 49% with imatinib over four years. Overall survival rates over four years were 88% for dasatinib and 69% for imatinib.
The study, published in JAMA Oncology, enrolled 189 patients with Ph+ ALL at 20 major hospitals in China. 92 received dasatinib, and 97 received imatinib. All had intensive chemotherapy without prophylactic cranial radiation, while only four underwent stem cell transplantation.
Dr Ching-Hon Pui, corresponding and co-senior author from St. Jude Department of Oncology, said: “This was a very fruitful collaboration. No single institution could enrol enough patients to do this kind of randomised clinical trial. By working with the Chinese Children’s Cancer Group, we were able to answer which targeted therapy provides the most benefit.”
Findings from the clinical trial were reported at the European Society for Paediatric Oncology and American Society of Hematology annual meetings in 2019. These announcements have since led to the inclusion of dasatinib for the treatment of Ph+ ALL in clinical protocols in the US and Europe going forward.
Shen S, Chen X, Cai J, Yu J, Gao J, Hu S, Zhai X, Liang C, Ju X, Jiang H, Jin R, Wu X, Wang N, Tian X, Pan K, Jiang H, Sun L, Fang Y, Li CK, Hu Q, Yang M, Zhu Y, Zhang H, Li C, Pei D, Jeha S, Yang JJ, Cheng C, Tang J, Zhu X, Pui CH (2020) “Effect of Dasatinib vs Imatinib in the Treatment of Pediatric Philadelphia Chromosome–Positive Acute Lymphoblastic Leukemia”, JAMA Oncology, doi: 10.1001/jamaoncol.2019.5868