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Updated: Mar 2, 2026
Pre-clinical Evaluation of Tyrosine Kinase Inhibitors for Treatment of Acute Leukemia
Published on: September 18, 2013
Treating the chronic-phase chronic myeloid leukemia patient: which TKI, when to switch and when to stop?
Ami B Patel1, Brandon W Wilds2, Michael W Deininger3
1a Huntsman Cancer Institute , The University of Utah , Salt Lake City , UT , USA.
Introduction:
With the discovery of imatinib mesylate nearly 20 years ago, tyrosine kinase inhibitors (TKIs) were found to be effective in chronic myeloid leukemia (CML). TKI therapy has since revolutionized the treatment of CML and has served as a paradigm of success for targeted drug therapy in cancer. Several new TKIs for CML have been approved over the last two decades that exhibit improved potency over imatinib and have different off-target profiles, providing options for individualized therapy selection. Areas covered: Current management of chronic phase CML, including guidance on the sequential use of imatinib and newer-generation TKIs and evolving treatment strategies such as TKI discontinuation. Relevant literature was identified by searching biomedical databases (i.e. PubMed) for primary research material. Expert commentary: Although survival outcomes have drastically improved for CML patients, treatment for CML has grown more complex with the introduction of next-generation TKIs and the advent of treatment-free remissions (TFR). Goals of therapy have shifted accordingly, with increased focus on improving quality of life, managing patient expectations and optimizing patient adherence.
Insights
Tyrosine kinase inhibitors (TKIs) have transformed chronic myeloid leukemia (CML) treatment. Newer TKIs offer improved efficacy and options for treatment-free remission, shifting focus to quality of life.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- Tyrosine kinase inhibitors (TKIs) revolutionized chronic myeloid leukemia (CML) treatment since imatinib's discovery.
- Over two decades, newer TKIs with enhanced potency and distinct off-target profiles have emerged for CML management.
Purpose of the Study:
- To review current management strategies for chronic phase CML.
- To discuss sequential TKI use, newer-generation TKIs, and treatment-free remission (TFR) approaches.
- To highlight evolving therapeutic goals in CML, emphasizing quality of life and adherence.
Main Methods:
- Literature search of biomedical databases, including PubMed, for primary research.
- Analysis of current clinical practice guidelines and expert commentary on CML treatment.
Main Results:
- TKI therapy has drastically improved survival outcomes for CML patients.
- Introduction of next-generation TKIs and TFR has increased treatment complexity.
- Treatment goals are shifting towards enhanced quality of life and patient adherence.
Conclusions:
- Modern CML management involves complex decisions regarding sequential TKI use and TFR.
- Optimizing patient quality of life, managing expectations, and ensuring adherence are critical.
- Individualized therapy selection is key in the evolving landscape of CML treatment.
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