Second TKI listed on PBS for adults with Ph+ALL 

Blood cancers

By Michael Woodhead

1 Aug 2019

Prof Andrew Grigg

Patients with Philadelphia chromosome positive acute lymphoblastic leukaemia (Ph+ ALL) will have subsidised access to dasatinib (Sprycel) from August 1.

Newly diagnosed adult patients (aged 18 years and over) Ph+ ALL will be eligible for PBS subsidised treatment with the TKI  as a first line oral therapy, when this is integrated with chemotherapy.

Professor Andrew Grigg, Director of Clinical Haematology at Austin Health welcomed the listing as an additional treatment option for Ph+ ALL patients, who would otherwise have to pay $52,000 per year for the drug.

“Tyrosine kinase inhibitors (TKI) have been shown to significantly improve the outcome of patients with this uncommon leukaemia,” he said.

“Until now the only TKI approved was imatinib, which was not always well tolerated in this condition. Having dasatinib available as an option gives us flexibility in choosing the TKI which is most likely to be tolerated long-term by patients.”

According to manufacturer Bristol Myers Squibb, around 390 cases of ALL are diagnosed in Australia each year, of which about 45% are in adults. Of the approximately 185 adults who are diagnosed with ALL each year, about 25% (45 patients) have the Philadelphia chromosome (Ph+).

The company says that dasatanib is now reimbursed for all approved indication, which include treatment of adults with newly diagnosed Ph+ chronic myeloid leukaemia (CML) in the chronic phase; chronic, accelerated or myeloid or lymphoid blast phase CML with resistance or intolerance to prior therapy including imatinib; and Ph+ ALL with resistance or intolerance to prior therapy.

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