I just got my 19-month PCR results. I started on Gleevac for the first year and have been on 100 mg Sprycel for about 6 months.
All results are International Scale (IS).
8 months - 5.5%
11 months - 1.062%
- 15-day drug break -
14 months - 0.9272% - CCyR FISH
15 months - 0.608%
19 months - 0.394%
I'm happy that I'm making progress although I had hoped for better response with Sprycel. Although I hit CHR quickly and made CCyR, I've still have not reached MMR at 19 months.
My oncologist seems fine with the results and made the point that changes in treatment protocol wouldn't be warranted unless a significant event took place (loss of CCyR or blood counts going crazy). Many current studies support this as well. Strange thing is that he mentioned that he doesn't recommend doing another PCR in 3 months. He only ordered a CBC/CMP. I have never heard of this especially considering I'll be very close to the 2-year mark and would want to know if I've reached MMR or if I'm trending upward.
If you're on the "right" TKI, shouldn't you see a more rapid response? Should I consider Tasigna, Bosulif, or Ponatinib?
It seems like opinion on CCyR and MMR has changed a lot in the last 4 or 5 years. I'd love to get feedback if you have any. An interesting study from this year discusses response rates: http://www.ncbi.nlm....les/PMC3943308/.
Anyway, I happen to have another appointment at Hopkins in a couple of months and will have all of the tests done just to be sure. I just thought this line of thinking was interesting considering my "slow" response rate. Also wondering if the continual PCR test drama is really worth it. Should we just know what stage we're in (CHR, MCyR, CCyR, MMR, CMR) rather than going crazy over every little uptick or downtick?