Targeted cancer drugs for chronic myeloid leukaemia

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 and 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.

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.

Diagram showing how growth factor inhibitors stop the signal inside the cell

When do you have TKIs 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 (Glivec)

There are other types of TKI you might have as your first treatment. These include:

  • dasatinib (Sprycel)
  • nilotinib (Tasigna)

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 (Sprycel)
  • nilotinib (Tasigna)
  • bosutinib (Bosulif)
  • ponatinib (Iclusig)
  • asciminib (Scemblix)

Blast phase CML

You might take a TKI drug alongside chemotherapy, if you have blast phase CML.   

How you have targeted cancer drugs for CML

You usually take TKI drugs as tablets every day. Your treatment team will tell you how often and when you need to take these.

You usually carry on taking the drug if it is controlling your CML. And if your side effects are not too severe.

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.

You should take the right dose, not more or less.

Talk to your healthcare team before you stop taking or miss a dose of a cancer drug.

Side effects

Many people are worried about the possible side effects of treatment. All treatments cause some side effects. But side effects vary from one person to another.

Side effects depend on what treatment you have. There are several types of drug treatments for CML. These have different side effects.  You can look up your treatment drugs on our cancer drug list and read about the side effects.

Your treatment team can help to manage any side effects that you have. They might give you drugs to help with certain side effects such as anti sickness medicines.

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 above 37.5C or below 36C.

Last reviewed: 
21 Jul 2022
Next review due: 
21 Jul 2025
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    The National Institute for Health and Care Excellence (NICE), August, 2016

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    A. Hochhaus and others

    Annals of Oncology, 28, (Supplement 4) pages 41-51, 2017

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    A. Hochhaus and others
    Leukemia (2020) Volume 34, pages 966–984

  • Chronic myeloid leukaemia
    J Cortes and others
    Lancet 2021, Volume 398, issue 10314, pages 1914-1926

     

  • A British Society for Haematology Guideline on the diagnosis and management of chronic myeloid leukaemia
    G Smith and others
    British Journal  of  Haematology, 2020, volume 191 pages 171–193

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