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Research and new methods

New tyrosine kinase inhibitors

Tyrosine kinase inhibitors (TKIs) transformed the treatment of CML and Ph-positive ALL. Newer generations of TKIs open up options when there is resistance or intolerance.

Last updated: ~1 min read
Close-up of tablets in blister packs
Figure 1.New TKIs are usually taken as tablets

01Short answer

After the first generation came more potent second- and third-generation medicines, some of which also act on specific mutations that cause resistance. A newer approach, allosteric inhibitors, binds the protein at a different site and can work in some resistant cases. Research is also studying whether TKIs can be stopped under supervision after a deep, lasting response (treatment-free remission); this is done only under a doctor's care. The choice of TKI depends on mutations, other illnesses and the side-effect profile.

02Simple explanation

Progress over generations.

The allosteric approach.

Stopping: only under supervision.

Choice: individual.

03Scientific explanation

NCI: tyrosine kinase inhibitors are targeted medicines that block the BCR::ABL1 protein in CML.

NCI: new treatments are tested step by step, from the laboratory to clinical trials; only those proven safe and beneficial become standard care.

04What happens in the body?

ATP pocket

Where classic TKIs bind.

Another pocket
Figure 2.Another pocket — New tyrosine kinase inhibitors

Treatment-free remission

Control without medicine after a deep response.

Generations
Figure 3.Generations — New tyrosine kinase inhibitors

How to read the news

Research news brings hope, but not every advance suits everyone. Look at who it was tested in, at what phase and in how many people.

Talk to your doctor

Show your doctor what you have read; they will explain how it relates to your diagnosis and treatment. Do not change your treatment on your own.

05From research news to a conversation: four steps

Read, check, ask, decide together.

Read — From a trusted source.1ReadFrom a trusted source.
Check — Phase, participants, result.2CheckPhase, participants, result.
Ask — Show your doctor.3AskShow your doctor.
Decide — Together, without rushing.4DecideTogether, without rushing.
SourceA trusted site.
DoctorA personal explanation.
SafetyNot changing treatment yourself.

06Key points at a glance

TopicIn brief
ATP pocketWhere classic TKIs bind.
Treatment-free remissionControl without medicine after a deep response.
How to read the newsResearch news brings hope, but not every advance suits everyone. Look at who it was tested in, at what phase and in how many people.
Talk to your doctorShow your doctor what you have read; they will explain how it relates to your diagnosis and treatment. Do not change your treatment on your own.

07Key terms

TKI
Tyrosine kinase inhibitor.
Allosteric
Binding away from the active site.
Clinical trial
Testing a new treatment with volunteers.
Evidence
A result confirmed by reliable research.

08Key points

  • Monitor.
  • Take it.
  • Ask.
  • Check the source.
  • Talk to your doctor.

09Frequently asked questions

Can I stop my TKI myself?

No; only by your doctor's decision and with close monitoring.

What if side effects are heavy?

Switching to another TKI is possible; tell your doctor.

Is this advance right for me?

Only your treating doctor can say, based on your diagnosis, stage and condition.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Can I stop my TKI myself?

  2. What if side effects are heavy?

  3. Is this advance right for me?

My questions

12Sources

  1. National Cancer Institute. NCI Dictionary of Cancer Terms: tyrosine kinase inhibitor
  2. National Cancer Institute. Chronic Myelogenous Leukemia Treatment (PDQ®) – Patient Version
  3. National Cancer Institute. What Are Clinical Trials?
  4. National Cancer Institute. Phases of Clinical Trials
  5. National Cancer Institute. Using Trusted Resources
  6. National Cancer Institute. Patient Safety in Clinical Trials
  7. National Cancer Institute. NCI Dictionary of Cancer Terms: informed consent
  8. NIHR. Be Part of Research
  9. NHS. Clinical trials
  10. Cancer Research UK. Find a clinical trial
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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