In Reply We read with great interest the comments by Yun et al on our meta-analysis assessing the risk of vascular occlusive events (VOEs) with new-generation tyrosine kinase inhibitors (TKIs). We fully agree that, for all TKIs, dose-response and also clinical pharmacokinetics are of major importance for both efficacy and safety.1 The European Union’s Summary of Product Characteristics for ponatinib provides efficacy and safety data on dose-efficacy and dose-toxicity relationships and a similar description is proposed for nilotinib.2,3 However, we disagree with the estimates provided by Yun et al and we judge that their conclusion needs to be tempered.
Douxfils J, Haguet H, Dogné J. Multiple Causes of Cardiotoxic Effects in Patients With Chronic Myeloid Leukemia—Reply. JAMA Oncol. 2016;2(6):829. doi:10.1001/jamaoncol.2016.1011