Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
Laura Levy, DHSc, PA-C
OBJECTIVE: The objective of this selective EBM review is to determine whether or not bosutinib is effective and safe enough to be used as a fist line treatment option for patients who suffer from chronic myeloid leukemia.
STUDY DESIGN: This review consists of two randomized control trials and one cohort study.
DATA SOURCES: All articles were written in English and selected from peer reviewed articles published in PubMed or OVID. All articles were published between 2016 and 2018. Inclusion criteria that was used for the selection of studies for this review paper involved patients over the age of 18 who suffer from CML. Comparisons are made against newly diagnosed patients with CML, patients who are resistant or intolerant to TKI, and the use of aprepitant while administering bosutinib.
OUTCOMES: This review examined patient monitoring for adverse effects and questionnaires for assessing health-related quality of life. Common adverse effects that were monitored throughout various studies were gastrointestinal disorders, including abdominal pain, nausea, vomiting, and diarrhea.
RESULTS: Bosutinib has been shown to have an increase in therapeutic response at 12 months while decreasing disease progression to accelerated or blast phase and decreasing death rates. Patients who were administered aprepitant while receiving bosutinib had a significant decrease in gastrointestinal side effects such as nausea and vomiting. Overall health-related quality of life surveys indicated that patients who were treated with bosutinib showed a consistent improvement from baseline and their quality of life was not decreased while being treated with bosutinib.
CONCLUSION: Bosutinib has had recent FDA approval and can be used as first line treatment for patients who are newly diagnosed with Ph+ CML. Bosutinib has shown to decrease disease progression and death rates. Co-administration with aprepitant can help decrease common gastrointestinal side effects. Further research needs to be completed on long term side effects and variations in dosage.
McGoldrick, Alison, "Is Bosutinib Effective and Safe Enough to Be Used as a First Line Treatment Option for Patients Who Suffer from Chronic Myeloid Leukemia?" (2019). PCOM Physician Assistant Studies Student Scholarship. 488.