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Dasatinib dose management for the treatment of chronic myeloid leukemia
Authors: Moshe Talpaz MD, Giuseppe Saglio MD, Ehab Atallah MD, Philippe Rousselot MD, PhD
First published: 25 January 2018
Available data have suggested that administering dasatinib below currently approved doses may minimize AEs and maintain efficacy. Drug holidays (days of treatment respite) as an alternative to dose reductions is another means with which to mitigate AEs while keeping efficacy high. Maintenance therapy (administering a drug at a different dosing schedule to maintain a desired level of response) may be a suitable treatment goal, and data from current trials should aid in developing guidelines for what maintenance therapy should be. Treatment discontinuation often is a goal of CML treatment and certain patients may be well suited to withdraw from dasatinib therapy. Close follow-up and dose re-escalation, dose reinitiation, or switching to another TKI would be recommended for patients who demonstrate evidence of disease progression (eg, confirmed increase in BCR-ABL1 levels by polymerase chain reaction). Ultimately, treatment decisions will be made through discussions between physicians and patients. The questions of when to reduce doses, for whom to reduce doses, and by how much to reduce doses cannot be settled until data from prospective studies have been analyzed.