ArticleFrontiers in pharmacology2026
Low-dose dasatinib in second-line therapy or beyond for the treatment of chronic-phase chronic myeloid leukemia: a real-world cohort study.
Article in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Dasatinib is a favorable option for patients with chronic-phase chronic myeloid leukemia (CML-CP) who have an inadequate response, treatment intolerance, or are attempting treatment-free remission (TFR). Dasatinib dose reduction is a strategy to improve tolerability while maintaining efficacy in first-line settings or patients with a stable molecular response. However, whether low-dose dasatinib is safe and effective in second-line or later setting for patients with CML-CP remains unclear. Methods: We conducted a retrospective analysis of 53 patients with CML-CP who switched to low-dose dasatinib due to inadequate molecular response (n = 37), treatment intolerance (n = 13), or to re-induce a deeper molecular response (n = 3). Results: Among the 37 patients who had not achieved major molecular response (MMR) before switching, 10 patients (27.0%) attained MMR, 12 patients (32.4%) achieved deep molecular response (DMR/MR4), and 11 patients (29.7%) reached molecular response 4.5 (MR4.5) following low-dose dasatinib therapy. Notably, 81.8% of patients with only baseline MMR improved to MR4 or MR4.5 after switching to low-dose dasatinib. One patient lost MR4 while receiving dasatinib at 50 mg/day and subsequently switched to nilotinib. All three patients who were switched to re-induce deeper molecular responses successfully re-attained MR4.5 after switching to low-dose dasatinib. Adverse events resolved in all 13 patients who switched due to prior TKI intolerance, and no worsening grade 2 or more adverse events were observed. Conclusion: Our findings suggest that low-dose dasatinib for selected patients with CML-CP in second-line therapy or beyond may be safe and effective under close monitoring. Nevertheless, multicenter prospective clinical trials are needed to validate the efficacy and safety of low-dose dasatinib therapy in second-line treatment settings or beyond in CML.
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