Rmatologic toxicity Rash was one of the most common nonhematologic AEs
Rmatologic toxicity Rash was one of the most common nonhematologic AEs [24,25]. In the IRIS study, rash occurred in 34 , although grade 3-4 rash was infrequent (2 ). Pruritus (7 ) and AG-221MedChemExpress Enasidenib alopecia (4 ) were also noted in smaller numbers of patients [25]. In the DASISION trial, first-line dasatinib treatment resulted in fewer cases of rash compared with imatinib treatment (11 vs 17 ), with grade 3-4 rash occurring in 0 vs 1 , respectively. No rates were provided for pruritis or alopecia, suggesting that the frequencies were < 10 in both arms [12]. In the MDACC study, 58 of patients experienced "skin toxicity" (grouped term) with dasatinib, which was grade 3-4 in 2 . In addition, 8 experienced pruritus of which 2 was grade 3-4 [13]. Dermatologic toxicity seems to be more common with nilotinib than imatinib. In the ENESTnd trial, rash occurred in 31 taking nilotinib 300 mg BID, 36 taking nilotinib 400 mg BID, and 11 taking imatinib (grade 3-4 in < 1 vs 3 vs 1 , respectively). Pruritus was also more common in both nilotinib arms (15 with 300 mg BID and 13 with 400 mg BID) compared with imatinib (5 ), as was alopecia (8 with nilotinib 300 mg BID, 13 with nilotinib 400 mg BID, and 4 with imatinib) [14]. In single-arm trials of first-line nilotinib 400 mg BID, rash occurred in 49 (2 grade 3-4) of patients in the MDACC trial [15] and in 42 (5 grade 3) in the GIMEMA trial [4]. Pruritus also occurred in 21 of patients in the GIMEMA trial (4 grade 3). Gastrointestinal symptoms Nausea, diarrhea, and vomiting are common in patients receiving BCR-ABL inhibitor therapy, although recent data indicate that gastrointestinal (GI) disturbances occur less often in patients receiving dasatinib or nilotinib compared with those receiving imatinib. In the DASISION trial, nausea (8 v 20 ) and vomiting (5 vs 10 ) both occurred less frequently with dasatinib compared with imatinib, whereas rates of diarrhea were similar (17 in both arms). Grade 3-4 diarrhea was reported in < 1-1 , and no patients in either arm experienced grade 3-4 nausea or vomiting [12]. In the MDACC trial of dasatinib, higher rates of GI AEs were reported, including diarrhea in 53 (2 grade 3-4), nausea in 45 (0 grade 3-4), and vomiting in 21 (0 grade 3-4) [13]. In the ENESTnd trial, rates of GI AEs were lower with nilotinib 300 mg and 400 mg vs imatinib, including nausea (11 vs 19 vs 31 ), diarrhea (8 vs 6 vs 21 ), and vomiting (5 vs 9 vs 14 ), of which 0-1 were grade 3-4 cases in all arms [14]. In the MDACC study of first-line nilotinib, nausea and diarrhea were reported in 38 and 21 of patients, respectively, (no grade 3-4), and diarrhea occurred in 7 (2 grade 3-4) [15]. In the GIMEMA study, 11 of patientsexperienced nausea/vomiting (1 grade 3-4) and 7 had diarrhea (2 grade 3) [4].Edema Fluid retention is common with imatinib, as shown by 56 of patients receiving imatinib in the IRIS trial experiencing superficial edema and 13 having weight gain [25]. First-line dasatinib and nilotinib treatment are associated with lower rates of edema. In the DASISION, superficial edema (grouped term) was PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/26024392 much less frequent with dasatinib (9 ) compared with imatinib (36 ), and rates of grade 3-4 superficial edema were low (0 vs < 1 , respectively) [12]. In the MDACC study of dasatinib, edema was reported in 32 of patients (no grade 3-4) [13]. In the ENESTnd trial, different types of edema were reported separately. In the nilotinib 300 mg BID, nilotinib 400 mg BID.