An Analysis of Dasatinib Treatment Patterns in Patients with Chronic Myeloid Leukemia After Experiencing Pleural Effusion During Dasatinib Therapy

Introduction: Treatment with dasatinib for chronic myeloid leukemia (CML) has been associated with development of pleural effusion, however data regarding its optimal management are limited. We examined treatment patterns and healthcare resource utilization (HCRU) and costs among patients with CML treated with dasatinib who experienced a subsequent pleural effusion. Methods: Adults with CML and >= 1 pharmacy claim for dasatinib in 2015-2018 who experienced pleural effusion after dasatinib were identified using data from claims databases. Results: Overall, 123 patients were eligible. After 1 year, of the 38.2% of patients with a dose modification, 72.3% did not switch treatment; amongst these patients, 70.6% continued treatment. Among patients with a stable dose after pleural effusion (61.8%), 57.9% later switched to another TKI. The mean (SD) duration of dasatinib treatment after pleural effusion was 262.0 (124.0) days for patients with a dose modification versus 149.1 (155.2) days for those with a stable dose (p < 0.001). HCRU and costs were similar between groups. Discussion/Conclusion: Dasatinib dose modification after pleural effusion was not always required; however, patients with dose modifications continued therapy for a longer duration with a lower rate of switching to another TKI versus patients who remained on a stable dose.

Automated summary

Treatment with dasatinib for CML may lead to pleural effusion, but the optimal management approach is unclear. In this study, we found that not all patients required dose modification after pleural effusion, and those with dose modifications had longer treatment duration and lower rate of switching to other targeted therapies compared to those with stable dose.