{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T03:21:33Z","timestamp":1784949693672,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T00:00:00Z","timestamp":1687564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Imatinib, dasatinib, and nilotinib are tyrosine kinase inhibitors (TKIs) approved in Italy for frontline treatment of chronic\u2010phase chronic myeloid leukemia (CP\u2010CML). The choice of TKI is based on a combined evaluation of the patient\u2019s and the disease characteristics. The aim of this study was to analyze the use of frontline TKI therapy in an unselected cohort of Italian patients with CP\u2010CML to correlate the choice with the patient\u2019s features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 1967 patients with CP\u2010CML diagnosed between 2012 and 2019 at 36 centers throughout Italy were retrospectively evaluated; 1089 patients (55.4%) received imatinib and 878 patients (44.6%) received a second\u2010generation (2G) TKI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Second\u2010generation TKIs were chosen for most patients aged &lt;45 years (69.2%), whereas imatinib was used in 76.7% of patients aged &gt;65 years (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). There was a predominant use of imatinib in intermediate\/high European long\u2013term survival risk patients (60.0%\/66.0% vs. 49.7% in low\u2010risk patients) and a limited use of 2G\u2010TKIs in patients with comorbidities such as hypertension, diabetes, chronic obstructive pulmonary disease, previous neoplasms, ischemic heart disease, or stroke and in those with &gt;3 concomitant drugs. We observed a greater use of imatinib (61.1%) in patients diagnosed in 2018\u20132019 compared to 2012\u20132017 (53.2%; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.002). In multivariable analysis, factors correlated with imatinib use were age &gt; 65 years, spleen size, the presence of comorbidities, and \u22653 concomitant medications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This observational study of almost 2000 cases of CML shows that imatinib is the frontline drug of choice in 55% of Italian patients with CP\u2010CML, with 2G\u2010TKIs prevalently used in younger patients and in those with no concomitant clinical conditions. Introduction of the generic formulation in 2018 seems to have fostered imatinib use.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34923","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T21:45:48Z","timestamp":1687643148000},"page":"2637-2644","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Determinants of frontline tyrosine kinase inhibitor choice for patients with chronic\u2010phase chronic myeloid leukemia: A\u00a0study from the Registro Italiano LMC and Campus CML"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9449-2621","authenticated-orcid":false,"given":"Mario","family":"Tiribelli","sequence":"first","affiliation":[{"name":"Division of Hematology and Bone Marrow Transplant Azienda Sanitaria Universitaria Friuli Centrale  Udine Italy"},{"name":"Department of Medical Area University of Udine  Udine Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7741-862X","authenticated-orcid":false,"given":"Roberto","family":"Latagliata","sequence":"additional","affiliation":[{"name":"Hematology Unit Ospedale Belcolle  Viterbo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1163-6162","authenticated-orcid":false,"given":"Massimo","family":"Breccia","sequence":"additional","affiliation":[{"name":"Hematology Department of Precision and Translational Medicine \u201cSapienza\u201d University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Capodanno","sequence":"additional","affiliation":[{"name":"Hematology Unit Azienda Unit\u00e0 Sanitaria Locale\u2010IRCCS  Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina","family":"Miggiano","sequence":"additional","affiliation":[{"name":"Hematology Department San Bortolo Hospital  Vicenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cavazzini","sequence":"additional","affiliation":[{"name":"Hematology Unit University of Ferrara  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Bucelli","sequence":"additional","affiliation":[{"name":"Division of Hematology Foundation IRCCS Ca\u2019 Granda\u2013Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Immacolata","family":"Attolico","sequence":"additional","affiliation":[{"name":"Hematology Section Department of Emergency and Organ Transplantation University of Bari  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina Leonetti","family":"Crescenzi","sequence":"additional","affiliation":[{"name":"Hematology San Giovanni Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabina","family":"Russo","sequence":"additional","affiliation":[{"name":"Hematology University of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Annunziata","sequence":"additional","affiliation":[{"name":"Hematology Unit Presidio Ospedaliero Moscati  Aversa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Sor\u00e0","sequence":"additional","affiliation":[{"name":"Institute of Hematology Fondazione Policlinico Universitario A. 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