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Dasatinib is a second-generation BCR::ABL1 pill that, combined with the immunotherapy blinatumomab, can put Ph-positive ALL into deep remission with no chemotherapy at all.
Approved in CML (2006) and Ph+ ALL (resistant, 2006; paediatric frontline with chemotherapy 2018). The GIMEMA D-ALBA trial (dasatinib induction then blinatumomab) achieved 18-month OS 95% and DFS 88% in adults, launching the chemotherapy-free paradigm; long-term follow-up shows ~75% DFS at 4 years, with IKZF1-plus and T315I as the relapse drivers. Generic since 2024.
Dual SRC/ABL inhibitor binding active and inactive ABL1 conformations; inactive against T315I. Connects to BCR::ABL1 (Philadelphia chromosome), DDR2 receptor kinase and ABL1.
1.Dasatinib blocks BCR::ABL1 and SRC-family kinases in lymphoblasts
Background: ADC sequencing, Antigen escape (antigen loss, lineage switch), BCG-unresponsive, Castration-resistant prostate cancer (CRPC), Circulating tumour DNA (ctDNA). Also on OnCo: Resistance: how tumours escape each drug class · Lines of therapy.
Source: US prescribing information (DailyMed). Doses are for orientation; the current label governs.
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026). Generic dasatinib launched in the US in 2024.
Many commercial plans require generic imatinib first for chronic-phase CML unless there is a documented reason for a second-generation TKI; the generic is now preferred over Sprycel.
Part D out-of-pocket capped at $2,000 (2025) / $2,100 (2026). Medicare patients cannot use manufacturer co-pay cards; charity funds (PAN, HealthWell, CancerCare) and the Extra Help subsidy are the routes.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
Sources: NICE TA426 · SMC advice: dasatinib. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Chronic myeloid leukemia with resistance or intolerance to prior therapy including imatinib
Accelerated approval on a surrogate endpoint, with a confirmatory trial required.
Chronic myeloid leukemia with resistance or intolerance to prior therapy including imatinib
Confirmed: the accelerated approval of 2006 converted to traditional approval 2.9 years after it was granted.
Newly diagnosed adults with Philadelphia chromosome-positive CML in chronic phase
Accelerated approval on a surrogate endpoint, with a confirmatory trial required.
Newly diagnosed adults with Philadelphia chromosome-positive CML in chronic phase
Confirmed: the accelerated approval of 2010 converted to traditional approval 4.8 years after it was granted.
| Region | Year | Indication |
|---|---|---|
| US | 2006 | CML and Ph+ ALL resistant or intolerant to imatinib |
| US | 2018 | Paediatric Ph+ ALL with chemotherapy |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Pleural effusion CML long-term data | 28% | - |
| Myelosuppression Higher in ALL with chemotherapy | - | 50% |
| Pulmonary arterial hypertension Rare, reversible on stopping | - | - |
Rates read from the US prescribing information. Blank cells mean the figure was not sourced, not that it is zero.
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Dasatinib is preferred over imatinib for paediatric Ph-positive ALL in many protocols because of its central nervous system penetration and superior outcomes in this trial.
IRIS made imatinib the first-line standard for CML worldwide and established the tyrosine kinase inhibitor as a chronic, life-long oral therapy. For most patients CML became a manageable condition with near-normal life expectancy. Later generations of TKIs (dasatinib, nilotinib, asciminib) produce faster, deeper responses but have not shown a survival advantage over imatinib.
Query for this drug: (TITLE:"Dasatinib" OR ABSTRACT:"Dasatinib" OR TITLE:"Sprycel" OR ABSTRACT:"Sprycel") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Dasatinib, not a curated reading list.
Shares LYN kinase, HCK kinase, SRC family kinases, A Study of Oral Asciminib Versus Other TKIs in Adult Patients With Newly Diagnosed Ph+ CML-CP.
Shares ABL1, A Study of Oral Asciminib Versus Other TKIs in Adult Patients With Newly Diagnosed Ph+ CML-CP, Sokal and ELTS risk scores (chronic myeloid leukaemia), Ph-positive ALL.
Shares BCR::ABL1 TKI + blinatumomab (chemotherapy-free Ph+ ALL), ABL1, Ph-positive ALL, Transplant-free Ph-positive ALL for MRD-negative adults.
Shares A Study of Oral Asciminib Versus Other TKIs in Adult Patients With Newly Diagnosed Ph+ CML-CP, Sokal and ELTS risk scores (chronic myeloid leukaemia), IRIS: imatinib versus interferon plus cytarabine as first treatment for chronic myeloid leukaemia, BCR::ABL1 transcript (Philadelphia chromosome, quantitative PCR).
Shares BCR::ABL1 TKI + blinatumomab (chemotherapy-free Ph+ ALL), D-ALBA (GIMEMA LAL2116), Ph-positive ALL, Mixed-phenotype acute leukaemia.
Shares Dasatinib versus imatinib with chemotherapy for paediatric Philadelphia chromosome-positive acute lymphoblastic leukaemia (CCCG-ALL-2015), DASISION, A Study of Oral Asciminib Versus Other TKIs in Adult Patients With Newly Diagnosed Ph+ CML-CP, Sokal and ELTS risk scores (chronic myeloid leukaemia).
Shares BCR::ABL1 transcript (Philadelphia chromosome, quantitative PCR), BCR::ABL1 kinase domain mutations (T315I and others), Chronic myeloid leukaemia, chronic phase, Chronic myeloid leukaemia, accelerated and blast phase.
Shares BCR::ABL1 TKI + blinatumomab (chemotherapy-free Ph+ ALL), Ph-positive ALL, Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL), BCR::ABL1 (Philadelphia chromosome).