Considerations for early switch to nilotinib or dasatinib in patients with chronic myeloid leukemia with inadequate response to first-line imatinib.

Clinical evidence in chronic myeloid leukemia demonstrates a significant link between optimal response to tyrosine kinase inhibitor (TKI) therapy and favorable clinical outcome. For patients with suboptimal response to first-line TKI, clinical data show that a considerable proportion can be rescued by second-line TKI. Practice guidelines now recommend that clinicians consider a switch in TKI for patients with suboptimal response as early as 3 months after first-line TKI initiation, thus allowing clinicians to intervene in a timely manner and consider the potential benefit of a switch in TKI therapy.