Prof Timothy Hughes speaks to ecancer.tv about the ENESTnd trial which is evaluating the efficacy and safety of the second generation tyrosine kinase inhibitor nilotinib in newly diagnosed chronic myeloid leukaemia (CML) patients. This study compared standard imatinib treatment with nilotinib 300mg twice daily or nilotinib 400mg twice daily and found that both nilotinib regimens had superior efficacy over imatinib with significantly higher rates of major molecular response, complete cytogenetic response and significantly lower rates of progression to accelerated phase / blast phase. Prof Hughes discusses the differences in toxicity between the two agents and between the two nilotinib regimens, considers the benefits of putting patient straight onto nilotinib as first line treatment and talks about CML becoming a truly chronic manageable disease.