... which of the drugs would you choose? I know several people on here didn't really have a choice regarding first-line treatment when they were originally diagnosed -- Gleevec was the only option. So, pretend that you just found out today that you have CML (with the same counts, blasts, FISH, PCR, etc. as you had originally at diagnosis). Also pretend that you had all the knowledge you now have about CML, all 3 drugs currently available and their potential side effects. (I guess, if you want, you can even throw in the new trial drugs for the sake of discussion.) So, what is your choice?
[I was diagnosed on July 9, 2010, and I *think* I was one of the first ones (at least of those who post here) who was given Sprycel as first-line treatment outside of a trial. It wasn't even approved by the FDA at the time that I started. I do wonder every night when I take it if I made the best choice. (Actually, not sure it was really my choice, my onc. STRONGLY encouraged Sprycel.) Not that I am complaining about Sprycel -- I have had excellent results and not a lot of horrible side effects (although some of them do scare me, like increased BP, heartburn, flushing). I do also worry about the long-term effects (to my heart, lungs, etc.) with the potential P.E. and pulmonary hypertension side effects. I often say that I will probably die from one of the side effects but still be PCRU, not that it will matter at that point.
I am going to think some more about my answer to the question. I suspect I will still pick Sprycel, but starting at a lower dose than 100 mg. I started on 100 mg in July 2010 (PCRU Oct 2010), and switched to 70 mg a month ago. Assuming I can maintain PCRU at 70, I would like to eventually go down to 50 mg. However, money may change my answer after I think on it some more. My husband is a teacher, so our health insurance is horrible. I fork out a ton of money for Sprycel, so I probably should pick Gleevec. If I knew back then that I would be spending over $10k per year out of pocket, I definitely would have picked Gleevec.]