A Review of the Therapeutic Role of Bosutinib in Chronic Myeloid Leukemia

The development of the BCR::ABL1 tyrosine kinase inhibitors (TKIs) has transformed Philadelphia chromosome (Ph)- positive chronic myeloid leukemia (CML) from a fatal disease to an often -indolent illness that, when managed effectively, can restore a life expectancy close to that of the normal population. Bosutinib is a second -generation TKI approved for adults with Ph -positive CML in chronic phase, accelerated phase, or blast phase that is resistant or intolerant to prior therapy, and for newly diagnosed Ph -positive chronic phase CML. This review details the efficacy of bosutinib for the treatment of CML in the first- and second -line settings, as well as in third- and later -line settings for high -risk patients resistant or intolerant to at least 2 TKIs. It also outlines bosutinib studies that provide evidence for dose -optimization strategies that can be used to improve efficacy and effectively manage adverse events. The studies that provide evidence for specific patient populations benefiting particularly from bosutinib dose -optimization strategies are also discussed. The well -established, long-term side -effect profile and the potential to make dose adjustments with bosutinib make it an appropriate treatment option for patients with CML. Bosutinib has demonstrated a positive impact on health -related quality of life and an important role in the long-term treatment of patients with CML. Clinical Lymphoma, Myeloma and Leukemia, Vol. 24, No. 5, 285-297 (c) 2024 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ )