I have experienced 2 consecutive PCR increase (0.053% -> 0.144% -> 0.194%). My onc wants to stay the course, retest in 4 weeks, plus conduct mutation testing, BMB and talk transplant options then. Seems generally sensible, but I feel like an immediate TKI change from tasigna to spyrcel would be a good idea. Based on my reading of the literature, 2 consecutive pcr increases is a pretty robust indicator of treatment failure / pending relapse. So my thinking is - I'm getting minimal therapeutic benefit from nilotinib so why not try something else? The worst that could happen is failure on that drug as well, in which case nothing is lost.
Any thoughts would be appreciated.