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REVIEW article

Front. Oncol.
Sec. Hematologic Malignancies
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1446517

Therapeutic Options for Chronic Myeloid Leukemia Following the Failure of Second-Generation Tyrosine Kinase Inhibitor (TKI) Therapy

Provisionally accepted
Binsah George Binsah George *Kok Hoe Chan Kok Hoe Chan Adan Rios Adan Rios
  • University of Texas Health Science Center at Houston, Houston, United States

The final, formatted version of the article will be published soon.

    The management of chronic myeloid leukemia in the chronic phase (CML-CP) has witnessed significant advancements since the identification of a common chromosomal translocation anomaly involving chromosomes 9 and 22, which results in the formation of the Philadelphia chromosome driven by the BCR-ABL1 fusion protein. This discovery paved the way for the development of tyrosine kinase inhibitors (TKIs) that target the adenosine triphosphate (ATP) binding site of ABL1 through the BCR-ABL-1 fusion protein. Following the approval of Imatinib by the Food and Drug Administration (FDA) as the first TKI for CML treatment in 2001, the median overall survival (OS) for chronic phase CML (CML-CP) has significantly improved, approaching that of the general population. However, achieving this milestone crucially depends on reaching certain treatment response milestones. Since the introduction of imatinib, five additional TKIs have been approved for CML-CP treatment. Despite the availability of these treatments, many patients may experience treatment failure and require multiple lines of therapy due to factors such as the emergence of resistance, such as mutations in the ATP binding site of ABL, or intolerance to therapy. This review will primarily focus on exploring treatment options for patients who fail second-generation TKI therapy due to true resistance.

    Keywords: Chronic myeloid leukemia, Second-generation tyrosine kinase inhibitor, CML, TKI, failure, therapeutic options such as CHR, CCyR, and MMR with Newly Diagnosed Chronic Myeloid Leukemia in Chronic

    Received: 10 Jun 2024; Accepted: 15 Jul 2024.

    Copyright: © 2024 George, Chan and Rios. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Binsah George, University of Texas Health Science Center at Houston, Houston, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.