{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:08:43Z","timestamp":1790402923553,"version":"4.1.0"},"reference-count":69,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am Soc Clin Oncol Educ Book"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>\n            The choice of frontline therapy for a patient with chronic phase chronic myeloid leukemia (CP-CML) can have a profound effect on the long-term clinical outcome. Currently, five tyrosine kinase inhibitors (TKIs\u2014imatinib, dasatinib, nilotinib, bosutinib, and asciminib) are available for frontline therapy, but no single TKI is optimal for all patients. EUTOS long-term survival (ELTS) risk score, comorbidities, and treatment-free remission (TFR) priority are the key determinants of frontline TKI selection. Higher ELTS score, low age and comorbidity score, and a high priority for achievement of TFR would all favor the frontline use of a more potent TKI than imatinib. However, no TKI has improved survival compared with imatinib. In children with CP-CML, imatinib, dasatinib, and nilotinib have similar long-term efficacy, with ease of administration and impact of toxicities on quality of life being key considerations. Recent adult trials of reduced-dose dasatinib frontline showed that efficacy may be equivalent to standard-dose dasatinib with a better tolerability and safety profile, but experience is limited in patients with high-risk ELTS scores. The ASC4FIRST trial has confirmed that tolerability and molecular response with asciminib are superior to those with both imatinib and the second-generation (2G)-TKIs. While the overall treatment failure rate was lower with asciminib, the rate of BCR::ABL1 mutations that emerged with asciminib appeared to be higher. The risk of emergent mutations appears to be highly associated with the presence of\n            <jats:italic>ASXL1<\/jats:italic>\n            mutations in the CML cells at diagnosis, but more work is needed to understand the implications of this finding.\n          <\/jats:p>","DOI":"10.1200\/edbk-25-473082","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T19:59:12Z","timestamp":1745524752000},"source":"Crossref","is-referenced-by-count":9,"title":["Which Is the Best Tyrosine Kinase Inhibitor for Newly Diagnosed Chronic Myelogenous Leukemia?"],"prefix":"10.1200","volume":"45","author":[{"given":"Naranie","family":"Shanmuganathan","sequence":"first","affiliation":[{"name":"Precision Cancer Medicine Theme, South Australian Health &amp; Medical Research Institute, Adelaide, Australia"},{"name":"Department of Haematology, Royal Adelaide Hospital, Adelaide, Australia"},{"name":"School of Medicine, University of Adelaide, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Osborn","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Adelaide, Adelaide, Australia"},{"name":"Department of Haematology and Oncology, Women's and Children's Hospital, North Adelaide, Australia"},{"name":"Youth Cancer Service, Royal Adelaide Hospital, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy P.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Precision Cancer Medicine Theme, South Australian Health &amp; Medical Research Institute, Adelaide, Australia"},{"name":"Department of Haematology, Royal Adelaide Hospital, Adelaide, Australia"},{"name":"School of Medicine, University of Adelaide, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-020-01111-2"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.64.8899"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1609324"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022457"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-04-347575"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-014-1566-2"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2015.36"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-07-590315"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01589-y"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2024024657"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2400858"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17654"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26689"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2018025874"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.74.7162"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.38.7522"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2024012655"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2019-127619"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(21)00333-1"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neo.2016.07.005"},{"key":"e_1_3_3_22_2","first-page":"124","article-title":"Improved tolerability with dasatinib 5 days compared to 7 days per week in patients with chronic myeloid leukemia in chronic phase. 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