Summary

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• This summary is based on the review of 10 systematic review(s)/meta-analysis(es). ^[1-10]
• Second-generation tyrosine kinase inhibitors (TKIs) (dasatinib, nilotinib, radotinib) improve major molecular response (MMR) and complete cytogenetic response (CCyR) rates compared to imatinib, with imatinib 800 mg outperforming imatinib 400 mg in these measures; for third-line treatments, ponatinib achieves the highest MMR (19.0-66.7%) and CCyR (21.4-64.8%) rates, followed by asciminib, omacetaxine, and bosutinib.
• No significant differences were observed in 5-year overall survival (OS) or progression-free survival (PFS) between imatinib and second-generation TKIs (nilotinib, dasatinib); however, second-generation TKIs improved OS at 12 months relative to imatinib.
• New-generation tyrosine kinase inhibitors (NG-TKIs) enhance early molecular response at 3 months and reduce the rate of accelerated or blastic-phase transformations compared to imatinib.
• No significant difference was observed in the incidence of all-grade adverse events among various TKIs; however, all TKIs were associated with serious grade 3-4 hematologic adverse events, including anemia, thrombocytopenia, and neutropenia.
• Dasatinib showed a higher likelihood of causing anemia (54.5%), bosutinib had an increased risk of thrombocytopenia (35.3%), and imatinib was more associated with neutropenia (29.8%), while nilotinib presented lower severe hematologic adverse events.
• Second-generation TKIs (excluding dasatinib) were linked to a higher incidence of cutaneous adverse events, such as rash, pruritus, and alopecia, compared to imatinib, with an elevated risk of hepatotoxicity, notably with radotinib (400 mg) and imatinib (800 mg).
• There is no population type or subgroup information available in the reviewed studies.