Evaluation of cardiovascular ischemic event rates in dasatinib-treated patients using standardized incidence ratios

Ann Hematol. 2017 Aug;96(8):1303-1313. doi: 10.1007/s00277-017-3012-z. Epub 2017 May 22.

Abstract

With high survival rates for chronic myeloid leukemia (CML) patients treated with BCR-ABL1 tyrosine kinase inhibitors (TKIs), emerging consequences, such as arterial ischemic events, require consideration when evaluating treatment options. Cardiovascular ischemic event incidence in clinical trials was evaluated in 2712 dasatinib-treated patients with Philadelphia chromosome-positive (Ph+) leukemias from 11 first- and second-line trials (pooled), newly diagnosed CML patients treated with dasatinib or imatinib (DASISION), and prostate cancer patients treated with dasatinib or placebo plus docetaxel/prednisone (READY). Overall, 2-4% of dasatinib-treated patients had cardiovascular ischemic events. Most dasatinib-treated patients with an event had a history of and/or risk factor for atherosclerosis (pooled 77 with history/risk and event/96 with events; DASISION 8/10; READY 15/18). Most cardiovascular ischemic events occurred within 1 year of initiating dasatinib (pooled 69/96; DASISION 7/10; READY 16/18). Comparison of observed and expected event rates through standardized incidence ratios indicates that dasatinib does not increase risk for cardiovascular ischemic events compared with external reference populations.

Keywords: Cardiovascular; Chronic myeloid leukemia; Dasatinib; Ischemic; Tyrosine kinase inhibitors.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / epidemiology
  • Clinical Trials as Topic / methods
  • Clinical Trials as Topic / statistics & numerical data
  • Dasatinib / adverse effects*
  • Female
  • Humans
  • Incidence
  • Ischemia / chemically induced*
  • Ischemia / epidemiology
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Prostatic Neoplasms / drug therapy
  • Protein Kinase Inhibitors / adverse effects

Substances

  • Protein Kinase Inhibitors
  • Dasatinib