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DASISION showed that the second-generation drug dasatinib brought chronic myeloid leukaemia under control faster and more deeply than imatinib when used from diagnosis, though after five years patients lived equally long on either.
DASISION randomised 519 patients with newly diagnosed chronic-phase chronic myeloid leukaemia to dasatinib 100 mg once daily or imatinib 400 mg once daily. The primary endpoint was confirmed complete cytogenetic response by 12 months.
Dasatinib produced higher rates of complete cytogenetic and major molecular response at 12 months, and responses came sooner, which led to its first-line approval in 2010. With five years of follow-up the rates of progression to advanced phase were lower with dasatinib, but overall survival was the same in both arms, and pleural effusions were commoner with dasatinib. Together with ENESTnd (nilotinib) and BFORE (bosutinib), it established that second-generation inhibitors give faster, deeper responses without a survival advantage, which is why imatinib remains a reasonable first choice for many patients.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
547 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Confirmed complete cytogenetic response by 12 monthsprimary | Dasatinib 100 mg | 259 | 77% | - | 0.007 | link |
| Imatinib 400 mg | 260 | 66% | ||||
| Major molecular response by 12 months | Dasatinib 100 mg | 259 | 46% | - | <0.0001 | link |
| Imatinib 400 mg | 260 | 28% | ||||
| Progression to accelerated or blast phase | Dasatinib 100 mg | 259 | 1.9% | - | - | link |
| Imatinib 400 mg | 260 | 3.5% |
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