mg twice daily and
Gleevec 800 mg (400 mg twice daily) in 150 patients with chronic-phase CML
resistant to prior Gleevec doses of 400 or 600 mg. For patients receiving
SPRYCEL, at 12 weeks 36 percent achieved a major cytogenetic response, the
study's primary endpoint (29 percent with Gleevec), and 22 percent achieved
a complete cytogenetic response (8 percent with Gleevec). With longer
treatment and follow-up, 52 percent achieved a major cytogenetic response
(33 percent with Gleevec), and 40 percent of patients achieved a complete
cytogenetic response (16 percent with Gleevec). The rate of major
cytogenetic response with SPRYCEL was lower among patients aged 65 years
and over.
At the time of analysis, 39 of 49 patients receiving Gleevec had
crossed over to SPRYCEL; 15 of 101 patients receiving SPRYCEL had crossed
over to Gleevec. Crossover to alternate therapy was permitted in the event
of disease progression or intolerable toxicity. Median duration of
treatment prior to crossover was 14 months for SPRYCEL and three months for
Gleevec.
Incidence of selected adverse reactions (all grades) in the Phase 2
randomized study in patients receiving SPRYCEL 70 mg twice daily or Gleevec
800 mg daily (400 mg twice daily) included diarrhea (37%, 29%); fluid
retention events (36%, 43%) such as pleural effusion (23%, 0%), superficial
edema (17%, 41%), generalized edema (2%, 4%), congestive heart
failure/cardiac dysfunction (2%, 0%), pericardial effusion (1%, 0%),
pulmonary edema (3%, 0%), pulmonary hypertension (1%, 0%); nausea (24%,
33%); hemorrhage (18%, 8%) including gastrointestinal bleeding (3%, 0%),
and vomiting (10%, 24%).
In this same study, the frequency of Grade 3/4 neutropenia,
thrombocytopenia, and anemia was 63%, 56%, and 19%, respectively, in the
SPRYCEL group and 39%, 14%, and 8%, respectively, in the Gleevec group. The
frequency of Grade 3/4 hypocalcemia was 4% in the SPRYCEL group and 0% in
the Gleevec group.
Patients enrolled in this stu
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