The University of Southampton
University of Southampton Institutional Repository

Dasatinib, high dose imatinib and nilotinib for the treatment of imatinib-resistant chronic myeloid leukaemia: a systematic review and economic evaluation

Dasatinib, high dose imatinib and nilotinib for the treatment of imatinib-resistant chronic myeloid leukaemia: a systematic review and economic evaluation
Dasatinib, high dose imatinib and nilotinib for the treatment of imatinib-resistant chronic myeloid leukaemia: a systematic review and economic evaluation
Treatments for patients with CML have included hydroxycarbamide, interferon alfa, stem cell transplantation and acute leukaemia-style chemotherapy. More recently, tyrosine-kinase inhibitor drugs have been developed. Imatinib was the first tyrosine-kinase inhibitor to be used for treating CML. It is considered to be effective and is recommended by NICE for the treatment of CML in the first line.1 Subsequently, dasatinib and nilotinib, also tyrosine-kinase inhibitors, have been developed and are being used for the treatment of CML.

Guidance on second-line treatment for those patients developing resistance to imatinib is less clear. In clinical practice, imatinib at high doses is frequently used. Dasatinib and nilotinib may also be treatment options. However, there have been no evaluations of the clinical and cost effectiveness of these treatments compared to each other or to most of the older treatment options for patients with imatinib-resistant CML. Economic evaluations of dasatinib and nilotinib compared to interferon alfa with cytarabine have been conducted (appendix 8 of CML assessment report2).

The function of this review is therefore to assess the clinical and cost effectiveness of high dose imatinib, dasatinib and nilotinib compared to each other or traditional technologies such as hydroxycarbamide, interferon alfa, stem cell transplantation and acute chemotherapy for the treatment of patients with imatinib-resistant CML.

This report is a part update of a previous report undertaken to inform the NICE MTA of dasatinib and nilotinib for people with imatinib resistant and imatinib intolerant CML,2 where the current report focuses on those with imatinib resistant disease only.

The HTA Programme commisioned this technology assessment report on behalf of the National Institute for Health and Clinical Excellence.
chronic myeloid leukaemia, dasatinib, imatinib
1366-5278
1-137
Loveman, Emma
06ff1bf1-0189-4330-b22d-f5a917e9871d
Cooper, Keith
ea064f58-d71d-404a-bcf3-49d243b8825b
Bryant, Jackie
cd84de60-e9a2-4d7a-8ec6-6ca6276b12aa
Colquitt, Jill L.
741c69a3-d9e0-4f10-b457-e496541e7915
Frampton, Geoff
26c6163c-3428-45b8-b8b9-92091ff6c69f
Clegg, Andrew J.
838091f5-39df-4dbe-a369-675b26f2301b
Loveman, Emma
06ff1bf1-0189-4330-b22d-f5a917e9871d
Cooper, Keith
ea064f58-d71d-404a-bcf3-49d243b8825b
Bryant, Jackie
cd84de60-e9a2-4d7a-8ec6-6ca6276b12aa
Colquitt, Jill L.
741c69a3-d9e0-4f10-b457-e496541e7915
Frampton, Geoff
26c6163c-3428-45b8-b8b9-92091ff6c69f
Clegg, Andrew J.
838091f5-39df-4dbe-a369-675b26f2301b

Loveman, Emma, Cooper, Keith, Bryant, Jackie, Colquitt, Jill L., Frampton, Geoff and Clegg, Andrew J. (2012) Dasatinib, high dose imatinib and nilotinib for the treatment of imatinib-resistant chronic myeloid leukaemia: a systematic review and economic evaluation. Health Technology Assessment, 16, 1-137. (doi:10.3310/hta16230). (PMID:22564553)

Record type: Article

Abstract

Treatments for patients with CML have included hydroxycarbamide, interferon alfa, stem cell transplantation and acute leukaemia-style chemotherapy. More recently, tyrosine-kinase inhibitor drugs have been developed. Imatinib was the first tyrosine-kinase inhibitor to be used for treating CML. It is considered to be effective and is recommended by NICE for the treatment of CML in the first line.1 Subsequently, dasatinib and nilotinib, also tyrosine-kinase inhibitors, have been developed and are being used for the treatment of CML.

Guidance on second-line treatment for those patients developing resistance to imatinib is less clear. In clinical practice, imatinib at high doses is frequently used. Dasatinib and nilotinib may also be treatment options. However, there have been no evaluations of the clinical and cost effectiveness of these treatments compared to each other or to most of the older treatment options for patients with imatinib-resistant CML. Economic evaluations of dasatinib and nilotinib compared to interferon alfa with cytarabine have been conducted (appendix 8 of CML assessment report2).

The function of this review is therefore to assess the clinical and cost effectiveness of high dose imatinib, dasatinib and nilotinib compared to each other or traditional technologies such as hydroxycarbamide, interferon alfa, stem cell transplantation and acute chemotherapy for the treatment of patients with imatinib-resistant CML.

This report is a part update of a previous report undertaken to inform the NICE MTA of dasatinib and nilotinib for people with imatinib resistant and imatinib intolerant CML,2 where the current report focuses on those with imatinib resistant disease only.

The HTA Programme commisioned this technology assessment report on behalf of the National Institute for Health and Clinical Excellence.

Full text not available from this repository.

More information

Published date: May 2012
Keywords: chronic myeloid leukaemia, dasatinib, imatinib
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 337668
URI: http://eprints.soton.ac.uk/id/eprint/337668
ISSN: 1366-5278
PURE UUID: 88dd5d95-541f-4255-a69a-0a14af85a5a2
ORCID for Geoff Frampton: ORCID iD orcid.org/0000-0003-2005-0497

Catalogue record

Date deposited: 02 May 2012 10:19
Last modified: 18 Feb 2021 16:41

Export record

Altmetrics

Contributors

Author: Emma Loveman
Author: Keith Cooper
Author: Jackie Bryant
Author: Geoff Frampton ORCID iD
Author: Andrew J. Clegg

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×