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Prognosis having achieved MMR: information from studies?


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#1 CMLSpouse

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Posted 18 July 2012 - 01:16 PM

Hi,

My spouse recently got the great news that he has achieved MMR - 3.1 log reduction after 9 months on Sprycel.  We're trying to figure out how best to communicate the significance of MMR and future prognosis to friends and family.   Most of the study data I've seen is focused on achieving MMR as the endpoint.   What sources would you suggest for looking at the probabilities going forward from MMR?

From the DASISION study (confusingly labeled 3 year followup though the data seems to be for 24 months), of Sprycel patients who achieved MMR at 12 months, 97% maintained MMR at 24 months.  7% had to discontinue the treatment between 12 and 24 months.  

I realize longer-term inferences will have to be drawn from the Gleevec studies, given limited history with Sprycel as a first-line treatment.  In any case, I'd appreciate any sources or references for studies which will help us characterize this very happy situation.

Thanks in advance!

Dave



#2 Trey

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Posted 18 July 2012 - 05:25 PM

Gleevec IRIS trials have shown that those who achieve MMR rarely lose that response (approx 1%).

The caveat is that if someone becomes intolerant over time to side effects of Sprycel, especially pleural effusion, then that can require switching to a drug that may not be as effective in some people.  This is a good rationale for reduced dosage after achieving PCRU, and maybe even after achieving MMR.



#3 CMLSpouse

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Posted 19 July 2012 - 12:25 AM

Thanks, Trey - that is helpful.  I couldn't see where to find those IRIS results.



#4 scuba

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Posted 19 July 2012 - 07:59 AM

https://ash.confex.c...Paper23968.html

http://www.clinicalt...00006343&rank=1


Diagnosed 11 May 2011 (100% FiSH, 155% PCR)

with b2a2 BCR-ABL fusion transcript coding for the 210kDa BCR-ABL protein

 

Sprycel: 20 mg per day - taken at lights out with Quercetin and/or Magnesium Taurate

6-8 grams Curcumin C3 complex.

 

2015 PCR: < 0.01% (M.D. Anderson scale)

2016 PCR: < 0.01% (M.D. Anderson scale) 

March        2017 PCR:     0.01% (M.D. Anderson scale)

June          2017 PCR:     "undetected"

September 2017 PCR:     "undetected"





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