3 replies to this topic

[JoshLee]

Hi All,

     So I finally made the switch to Sprycel. After a year of a "good" but not great response to Tasigna I decided to see Dr. Talpaz. A BMB showed 0/20, fish was 0/200, but PCR was 3% IS. Dr. Talpaz told me that since I am young (28), he wants to push for a deeper molecular response so I started taking 70 mg of Sprycel this morning. I see most people take 100 mg, is that standard? I don't really feel like questioning one of the foremost experts on CML so I thought I would ask others what they are taking? Thanks for your help.

[Trey]

Although 100mg is the recommended dosage for newly diagnosed and resistant patients, those who are CCyR (roughly 2 log response) as you are may not need the full dosage.  Dr Talpaz would prefer to see how you respond to 70mg and increase the dosage if needed.  That seems very reasonable. 

[CallMeLucky]

The incidence of pleural effusions has been higher than originally thought.  I think the experts like Talpaz are questioning if 100mg is too high of a dose given how powerful the drug is and that there are a growing number of patients it seems on lower dose who are doing well.  He can always increase your dose, but if it works at 70mg, then no need to risk the side effects.

[scuba]

Dr. Cortes starts many of his patients at 70mg. Sprycel. He started me at 70mg. and then quickly dropped it to 20mg. where I have been for over a year and a half. It seems the "experts" (Talpaz/Cortes) know something that the general Oncologist/Hematologist community does not. Namely that 100mg. Sprycel is too much. Cortes team told me they see many patients with Pleural effusion and severe myelosuppression at the 100mg. dose. The lower the dose, the less they see these problems.

One additional note. After my good response with 20mg. Sprycel, I asked - practically demanded - that my dose be increased to at least 40-50mg. so I could strive for a faster, deeper response. I was told by Dr. Cortes in strong terms, "NO". He told me, 'you are getting a great response on 20 - that is your dose, be happy.'  Interesting answer.