Dasatinib Holiday for Improved Tolerability

Inclusion Criteria:

• Male or female patients with diagnosis of CP-CML with cytogenetic confirmation of Ph+chromosome [t(9;22)(q34;q11)].
• Ph negative cases or patients with variant translocations who are BCR-ABL positive inmultiplex PCR4 will be also considered eligible.
• ECOG performance status ≤2.
• Age ≥ 18 years old (no upper age limit is given)
• Serum levels of potassium, magnesium and total calcium within the normal limits (≥LLN [lower limit of normal] and ≤ULN [upper limit of normal]). Correction of electrolytes'levels with supplements to meet enrolment criteria is allowed.
• AST and ALT ≤2.5 x ULN or 5.0 x ULN if considered due to leukemia
• Alkaline phosphatase ≤2.5 x ULN unless considered due to leukemia
• Total bilirubin ≤1.5 x ULN, except known Gilbert disease
• Serum creatinine ≤2 x ULN
• Written informed consent prior to any study procedures being performed. For 1st-line patients:

• Pre-treatment with hydroxyurea up to 6 months and imatinib or dasatinib for duration ofup to 4 weeks is permitted. For ≥ 2nd-line patients:

• Patients with treatment failure according to the 2013 ELN Recommendations criteria3 ortreatment intolerance as assessed by the investigator after prior treatment with TKIs otherthan dasatinib (imatinib, nilotinib, bosutinib, ponatinib).

Exclusion Criteria:

• Previous allogeneic stem cell transplantation (AlloSCT)
• Known impaired cardiac function, including any of the following:
• Congenital long QT syndrome
• History of or presence of clinically significant ventricular or atrialtachyarrhythmia
• QTc >450 msec on screening ECG
• Myocardial infarction within 6 months prior to starting therapy
• Other clinical significant heart disease (e.g. unstable angina pectoris, congestiveheart failure)
• Acute or chronic viral hepatitis with moderate or severe hepatic impairment (Child-Pugh scores >6), even if controlled
• Other concurrent uncontrolled medical conditions (e.g., active or uncontrolledinfections, acute or chronic liver and renal disease) that could cause unacceptablesafety risks or compromise compliance with the protocol
• Impaired gastrointestinal function or disease that may alter the absorption of studydrug (e.g., ulcerative disease, uncontrolled nausea, vomiting and diarrhea,malabsorption syndrome, small bowel resection or gastric by-pass surgery)
• Concomitant medications known to be strong inducers or inhibitors of the CYP450isoenzyme CYP3A4
• Patients who have undergone major surgery ≤2 weeks prior to starting study drug or whohave not recovered from side effects of such therapy
• Patients who are pregnant or breastfeeding or women of reproductive potential notemploying an effective method of birth control. Women of childbearing potential musthave a negative serum pregnancy test within 14 days prior to administration ofdasatinib. Post-menopausal women must be amenorrheic for at least 12 months in orderto be considered of non-childbearing potential. Male and female patients must agree toemploy an effective method of birth control throughout the study and for up to 3months following discontinuation of study drug
• Known diagnosis of human immunodeficiency virus (HIV) infection (HIV testing is notmandatory)
• Active autoimmune disorder, including autoimmune hepatitis
• Known serious hypersensitivity reactions to dasatinib
• Patients with a history of another primary malignancy that is currently clinicallysignificant or currently requires active intervention
• Patients unwilling or unable to comply with the protocol.