Most frequent mutations detected at a single institution, which accounted for 88% of all mutations
| Mutation . | No. detected . | Percentage of patients with mutations (n = 386) . | Percentage of all mutations (n = 503) . | Mutation class for therapeutic decision* . | |
|---|---|---|---|---|---|
| Nilotinib . | Dasatinib . | ||||
| T315I | 53 | 13.7 | 10.6 | D | D |
| M351T | 47 | 12.2 | 9.4 | A | A |
| G250E | 46 | 11.9 | 9.2 | A | A |
| F359V | 35 | 9.1 | 7.0 | C | A |
| M244V | 33 | 8.5 | 6.6 | A | A |
| Y253H | 32 | 8.3 | 6.4 | C | A |
| E255K | 27 | 7.0 | 5.4 | C | B |
| H396R | 26 | 6.7 | 5.2 | A | A |
| F317L | 22 | 5.7 | 4.4 | A | C |
| E355G | 16 | 4.1 | 3.2 | A | A |
| Q252H | 15 | 3.9 | 3.0 | B | B |
| E255V | 14 | 3.6 | 2.8 | C | B |
| E459K | 14 | 3.6 | 2.8 | A | A |
| F486S | 13 | 3.4 | 2.6 | A | A |
| L248V | 10 | 2.6 | 2.0 | A | A |
| D276G | 10 | 2.6 | 2.0 | A | A |
| E279K | 10 | 2.6 | 2.0 | A | A |
| Y253F | 6 | 1.6 | 1.2 | B | A |
| F359C | 6 | 1.6 | 1.2 | C | A |
| F359I | 6 | 1.6 | 1.2 | B | A |
| Mutation . | No. detected . | Percentage of patients with mutations (n = 386) . | Percentage of all mutations (n = 503) . | Mutation class for therapeutic decision* . | |
|---|---|---|---|---|---|
| Nilotinib . | Dasatinib . | ||||
| T315I | 53 | 13.7 | 10.6 | D | D |
| M351T | 47 | 12.2 | 9.4 | A | A |
| G250E | 46 | 11.9 | 9.2 | A | A |
| F359V | 35 | 9.1 | 7.0 | C | A |
| M244V | 33 | 8.5 | 6.6 | A | A |
| Y253H | 32 | 8.3 | 6.4 | C | A |
| E255K | 27 | 7.0 | 5.4 | C | B |
| H396R | 26 | 6.7 | 5.2 | A | A |
| F317L | 22 | 5.7 | 4.4 | A | C |
| E355G | 16 | 4.1 | 3.2 | A | A |
| Q252H | 15 | 3.9 | 3.0 | B | B |
| E255V | 14 | 3.6 | 2.8 | C | B |
| E459K | 14 | 3.6 | 2.8 | A | A |
| F486S | 13 | 3.4 | 2.6 | A | A |
| L248V | 10 | 2.6 | 2.0 | A | A |
| D276G | 10 | 2.6 | 2.0 | A | A |
| E279K | 10 | 2.6 | 2.0 | A | A |
| Y253F | 6 | 1.6 | 1.2 | B | A |
| F359C | 6 | 1.6 | 1.2 | C | A |
| F359I | 6 | 1.6 | 1.2 | B | A |
Class A indicates currently no compelling clinical evidence to suggest that the mutation would not respond to the inhibitor. Class B, In vitro assessment consistently indicates that the mutation may confer intermediate insensitivity38/resistance39 to the inhibitor, or clinical evidence may be suggestive of reduced sensitivity. At this stage, the presence of these mutations should have no impact on clinical decisions and additional clinical assessment is required before an alternative inhibitor would be recommended. Class C, Compelling clinical evidence to recommend an alternative inhibitor; V299L, which is very rarely detected in imatinib-treated patients, is a dasatinib class C mutation. Class D, No role for SGI therapy.