Targeted cancer drugs for chronic myeloid leukaemia (CML)
Targeted drugs work by targeting the differences in cancer cells that help them to grow and survive. There are many different types of targeted drugs.
The most common treatment for chronic myeloid leukaemia (CML) is a type of targeted cancer drug called a tyrosine kinase inhibitor (TKI).
Common TKIs for CML include:
- imatinib
- bosutinib
- dasatinib
- nilotinib
How do tyrosine kinase inhibitors work?
Tyrosine kinase inhibitors (TKIs) block chemical messengers (enzymes) called tyrosine kinases. Tyrosine kinases help to send growth signals in cells, so blocking them stops the cell growing and dividing.
TKIs are a type of targeted cancer drug called cancer growth blockers. Cancer growth blockers can block one type of tyrosine kinase or more than one type. TKIs that block more than one type of tyrosine kinase are called multi TKIs.
When do you have targeted cancer drugs for CML?
Most people take a TKI as their first treatment for CML. You usually take the TKI drug on its own, as your main treatment.
The most common first TKI drug for CML is:
- imatinib
There are other types of TKI you might have as your first treatment. These include:
- dasatinib
- nilotinib
You might switch on to a different TKI drug if:
- tests to look for signs of CML show that your CML hasn’t gone away
- tests detect signs of CML again after a period of time
- you have severe side effects from your current treatment
The next treatment you have depends on what TKI you have taken already. Some of the common next treatments for CML are:
- dasatinib
- nilotinib
- bosutinib
- ponatinib
- asciminib
Blast phase CML
Your doctor usually recommends you have a 
if you are well enough and have a stem cell donor for blast phase CML.
But some people in blast phase might have a TKI drug alongside chemotherapy or on its own.
Having targeted cancer treatment for CML
You usually take TKI drugs as tablets or capsules every day. This depends on the type of drug you have. Your treatment team will tell you how often and when you need to take these.
You usually carry on taking the drug for as long as the treatment is working, and you are not experiencing too many side effects.
Some people might be able to stop treatment if their CML is under control for a long time. This is called a treatment break. Your doctor can talk with you about whether a treatment break might be an option for you.
Taking your tablets or capsules
You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.
Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.
You should take the right dose, not more or less.
Talk to your healthcare team before you stop taking a cancer drug, or if you have missed a dose.
Side effects of targeted cancer drugs
Everyone is different and the side effects vary from person to person. The side effects you have depend on:
- which drug you have
- whether you have it alone or with other drugs
- the amount of drug you have (the dose)
- your general health
A side effect may get better or worse during your course of treatment. Or more side effects may develop as the treatment goes on. For more information about the side effects of your treatment, go to the individual drug pages.
When to contact your team
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
- you have severe side effects
- your side effects aren’t getting any better
- your side effects are getting worse
Early treatment can help manage side effects better.
Contact your doctor or nurse immediately if you have signs of infection. This includes a temperature of 37.5C or above. Or a temperature below 36C.
