Inhibiteur de tyrosine-kinase de seconde génération: place en 2012 en première ligne

摘要

In France, the only second-generation tyrosine-kinase inhibitor (2GTKIs) available as a first-line treatment is nilotinib. Trials comparing nilotinib with imatinib and dasatinib with imatinib favour 2GTKIs, which have faster, deeper and earlier molecular responses. However, a reduction in progress is also observed only in a small number of patients. Moreover, survival rates after 3 years are comparable for imatinib and 2GTKIs. For the initial imatinib prescription, it is important to take into consideration the early molecular response (between 3 to 6 months) so treatment modifications for patients considered as non-responders can be made as soon as possible. For prescriptions of 2GTKIs, it is important to take into consideration the comorbidities of patients and to implement a monitoring programme to detect and prevent emerging side effects.