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CML TKI Drug Side Effects Comparison

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#1 Trey


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Posted 17 October 2012 - 10:07 AM

Here is a chart showing the various side effects recorded for Gleevec, Sprycel and Tasigna during two major studies.  The chart may be useful for those who need to or want to reduce certain side effects, and are trying to decide which alternative drug would be the better choice:






The chart at the link above shows in general terms the following about each TKI drug.  Note that this chart records quantity, not severity of side effects:


Worst offenders for various side effects of each drug:

Gleevec induced more diarrhea, nausea, overall edema, muscle spasms/cramps, and phosphate decreases

Sprycel induced more pleural effusion, overall anemia, and low platelets

Tasigna induced more rash, itching, hair loss, elevated ALT and AST, elevated lipase and bilirubin


Most Favorable / Least side effects for each drug:

Gleevec induced the least of nothing (this may surprise some people)

Sprycel induced the least nausea and rash

Tasigna induced the least overall anemia


All Three Offended Equally Often Regarding:



Overall observations from this chart:

  • You can't run from the fatigue.  I think we knew that. 
  • Gleevec has a somewhat overall bad profile for numbers/types of side effects, although our collective experiences seem to show that severity of any given side effect may not be as severe.  Comparing the severity of Sprycel's pleural effusion issue shows that sometimes severity plays a greater role in the need to switch drugs than numbers of side effects.  But generally, Gleevec has NOT shown itself to have a better or milder side effects profile.
  • There are ways to trade side effects for others when necessary.  These drugs are just tools, not life-long loyalty partnerships.  Trading side effects can increase quality of life, not just provide a better response than another.

Edited by Trey, 09 August 2016 - 10:38 AM.

#2 Melanie


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Posted 17 October 2012 - 12:56 PM

Thanks Trey for this helpful tool. Is there enough data yet to add Bosutinib to the chart?


Dx - 05/2011; PCR: 15.04; Fish: 87% Slow responder due to pancytopenia. Current - Bosulif - Nov: 2012, Mar 2016 lowered to 300 mg. 07/16 back to 400 mg. Clinical trial drug, Promacta, Feb 2013, for low Platelets.
CyCR - Aug 2014, Positive for 1 chromosome Sep 2015. PCR: 12.77 in Oct, 2012 to 0.04 (MDA) in Mar, 2016. 4/2016 - 0.126 (Local lab (IS); 05/2016 - 0.195 (local); 6/2016 - 0.07 (MDA); 7/2016 - 0.03 (local) 9/13/2016 - 0.16 (MDA); 9/26/2016 - 0.31 (MDA); 11/2016 - 0.012 (local); 01/2017 - 0.24 (MDA); 04/2017 - 0.09 (MDA); Cytogenetics show der(1:7)(q10;p10)7 chromosome mutation. Repeat of Sep 2015. PCR - 6/2017- 0.035 (local); 10/2017- 0.02 (MDA)

#3 Trey


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Posted 17 October 2012 - 01:25 PM

There is limited data, but the clinical trials showed about the same types of issues: fatigue, diarrhea, muscle cramps, bone pain, rash, low WBC, low platelets.  But I do not have any direct comparison with the other drugs, which was my main purpose here.

#4 WoofWoof


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Posted 17 October 2012 - 05:57 PM

Very good info here and timely for me, thanks.

I have cancer but it doesn't have me

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