Uses

Indicated for adult patients with chronic phase, accelerated phase, or blast phase Philadelphia chromosome-positive chronic myelogenous leukaemia (Ph+ CML) that is resistant or intolerant to prior therapy.

Do not use if

Contraindicated in patients with known hypersensitivity to bosutinib. Reactions have included anaphylaxis.

Side effects

Common adverse effects include diarrhoea, nausea, vomiting, abdominal pain, elevated liver enzymes, thrombocytopenia, anaemia, neutropenia, rash, and fluid retention. Cardiovascular toxicity and myelosuppression are clinically significant.

Warnings

Monitor liver function tests, complete blood counts, and fluid status regularly. Withhold, dose reduce, or discontinue based on gastrointestinal toxicity, myelosuppression, hepatotoxicity, and cardiovascular events. Can cause embryo-foetal toxicity; contraception is required during treatment.

How it works

Bosutinib is a tyrosine kinase inhibitor (TKI) that inhibits the BCR-ABL kinase driving CML pathogenesis and also inhibits Src-family kinases including Src, Lyn, and Hck. It inhibits 16 of 18 imatinib-resistant BCR-ABL mutant forms but does not inhibit T315I or V299L mutants.

Storage

Store at 20–25°C (68–77°F); excursions permitted between 15–30°C. Store in original bottle with desiccant. Keep container tightly closed.