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CML and combination imatinib-interferon


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#1 cousineg

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Posted 24 November 2011 - 11:29 AM

Some hematologists in Canada no longer believe in the efficacy of the combination imatinib-interferon. Is the additional side effects outweigh the benefits desired? Are they right?

See http://www.nejm.org/...6/NEJMoa1004095


#2 Trey

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Posted 24 November 2011 - 02:44 PM

83% of those who were taking Gleevec + interferon quit before this study was concluded.  Seems like a failure to me.



#3 cousineg

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Posted 25 November 2011 - 12:51 AM

I think they should redo the trial with 45 ug or less instead of 90 ug peginterferon alfa-2a and see how much will quit before the end of the study.

  ''In conclusion, we found that the combination of imatinib and peginterferon alfa-2a
increases the rates of molecular responses, as compared with imatinib alone,
though the combination is associated with substantial toxic effects that often
result in the discontinuation of peginterferon alfa-2a (e.g., 45ug per week)
might allow the combination to be given for a longer period and preserve its
apparent increased antitumor efficacy''
Extract at the end of this  article http://www.nejm.org/...6/NEJMoa1004095

Other links:

http://bloodjournal....325373.abstract

http://www.cmlsupport.org.uk/node/6444            more about Dr Talpaz

http://www.medscape....warticle/715592     more about Dr Jabbour

http://www.cml-found...ings/58-ash2009 === see Imatinib-Interferon combination

http://www.ncbi.nlm....um&ordinalpos=1

http://ash.confex.co...Paper23533.html



#4 Trey

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Posted 25 November 2011 - 09:52 AM

Then the results would be less favorable with reduced Interferon dosage.  Why not just use Sprycel or Tasigna for faster statistical results than Gleevec?  Use of Interferon is not "free" to the body, since it makes T-Cells more aggressive and will cause some form of autoimmune issues. 



#5 cousineg

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Posted 25 November 2011 - 01:51 PM

Thank you Trey,

                                        I was PCRU for two years but the test PCR became positive (log2.38 in September) and (log2.80 in October). I will maybe receive the result of November in two weeks. I had not stopped taking Gleevec, but I had a very stressful time this year.

           In my case, I have atrial fibrillation, hypertension and renal insufficiency. I can't take Sprycel because I take Coumadin. I take already Monocor (5mg) and Rythmol (600mg) for the atrial fibrillation. For some patients, Tasigna gives already heart palpitations. I am nervous about Tasigna because of my heart
condition
. But if I have a mutation, I will have no choice. Like most people, I want to stop taking TKIs. So, that is the reason why I suggested
taking Gleevec with Interferon. My hematologist said  that I have already too much side effects with Gleevec (400mg).

Bye, Gilles



#6 Trey

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Posted 25 November 2011 - 09:05 PM

There is no prohibition against taking Sprycel and Coumadin together.  Many take both.  The Sprycel dosing info says:

"Since Sprycel therapy may cause bleeding, tell your healthcare provider if you are using blood thinner medicine, such as Coumadin (warfarin sodium) or aspirin."  All TKI drugs "may cause bleeding", not directly, but indirectly by lowering platelet count in some patients.  If a patient's platelets are OK then they can usually take Sprycel.  But that is just lawyers covering themselves.  Patients can take both together unless their doc knows of a specific reason not to do it.

Some people may have no option but to take only Interferon.  That is not a very optimistic scenario.



#7 cousineg

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Posted 20 July 2012 - 11:47 AM

Using thw eHealthMe website, we can have a very small idea of the interactions between these drugs (Rythmol, Coumadin and one ITK) . Unfortunately we can't make a conclusion with a very small particpation.  We can observe that there are more CMLers (962 reports) taking Sprycel with Rythmol and Coumadin. I am scared about the results with Tasigna (cardiac failure and myocardial infarction).

A study of drug interactions between Gleevec and Rythmol  and Coumadin  from 2 reports  

On Jul, 20, 2012: 2 people who reported to have interactions when taking Coumadin, Rythmol, Gleevec are studied ( Alopecia,  Arthralgia, Dyspnea, Epistaxis....)

  

A study of drug interactions between Sprycel, Rythmol and Coumadin from 962 reports

On Jul, 20, 2012: 962 people who reported to have interactions when taking Rythmol, Coumadin, Sprycel are studied (Atrial
Fibrillation, Asthenia, Dyspnea, Fatigue, Hypotension ....)

A study of drug interactions between Tasigna, Rythmol and Coumadin from 5 reports

  On Jul, 20, 2012: 5 people who reported to have interactions when takingRythmol, Coumadin, Tasigna are studied
(Cardiac failiure, Myocardial infarction, .....)



#8 cousineg

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Posted 21 July 2012 - 05:13 AM

There is an interesting message about the subject  TOPIC: Interferon and CML






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