9 replies to this topic

[rmerikle]

Newly diagnosed and on a steep learning curve. Did some searches, but not finding anything that specifically explains the differences between Gleevec and Tasigna. It looks as if the study results for Tasigna are even better than Gleevec. Should we be asking the Dr. to start her on Tasigna instead of Gleevec?

[Shara]

You should check with her dr. but you should know that Gleevec's patent is expiring in January 2015 which will mean the prices for it will go down. Tasigna is several years newer and I am not sure when the cost for that particular drug will drop. Also, you will need to look at dietary issues. Gleevec you take with a full meal while Tasigna has a very strick set of rules for taking.  Gleevec is the oldest medication for CML on the market.  Myself, I look at it like this; if Gleevec doesn't work then I can switch to Tasigna; if Tasigna then doesn't work then I can switch to Spycril and so on.  I believe if you start with Tasigna they do not recommend switching to Gleevec.  Trey would know for sure.

[JPD]

Im sure Trey will be along at some point - thank you, Trey - but I think its sorta along the lines of Gleevec is the starter drug of choice.  They started me on Tasigna because my Sokal score was elevated (due to spleen size) but most people just start on Gleevec and go from there.  Basically, the deal with Tasigna and food is that you CAN NOT eat two hours before and one hour after taking the meds.  Digestion increases the strength of the meds and that could lead to heart events (PT prolongation) that are quite deadly.  Its a pain in the ass sometimes, but Ive been doing it for 9 months and its just something you get used to.

 

Take the pills, live your life, and wait for a "cure".

[Trey]

There is no TKI which is superior for everyone.  So there is no compelling reason to start a patient on any particular drug vs another unless the patient is in advanced stage CML, then Sprycel is generally favored.   

 

The stats show Tasigna may bring faster responses in many cases, but Gleevec is still a great drug. 

 

Here is some info for you which may be useful, but again, there is no reason to avoid Gleevec.  And some insurance may require it as the initial drug.  If it doesn't work well enough she can always change drugs at any time.  Or if it makes her feel better about her treatment, there is also no reason not to start with Tasigna.

http://www.hemonctod....aspx?rid=30195

http://community.lls...vec#entry111336

Edited by Trey, 24 July 2014 - 08:57 PM.

[IGotCML]

I have been on Tasigna for 18 months since my diagnosis.  I agree with JPD that the 3 hour window of no food is still bothersome at times, even though it is well ingrained into my daily routine.  Insurance may also play a major factor in your decision, as posters have noted above.  My onc originally wanted me to start on Sprycell, but insurance would not allow it.

[rmerikle]

Thank you so much for all the responses. If I look at the two links provided by Trey then while there is not a huge difference these two links seem to confirm that Tasigna is the slightly superior drug. I have not had time to read the couple of pages worth of converation attched to the thread link, but looking at the shear numbers this is the conclusion I am comming to. I especially can understand there does not seem to be any reason to switch a drug if you are already on drug, but since my wife has not yet started yet we just want to make sure she starts on the best drug possible.

 

I actually work in the biotech industry on the Finance side working on a Phase 2 drug. I have mixed feelings about my wife possibly going on a clinical trial. At this time we are currently scheduled to have a multi hour talk with Fred Hutch on Aug 18th. We are suppose to discuss everything from transplant to Clinical studies. The thought is this will allow us enough time to retrieve eggs for down the road. And lastley she tends to take a conservative approach to a lot of things compared to me (waiting and meeting to discuss transplant) and more aggressive on others. She likes the idea of doing a clinical study which would put her on cutting edge and allow her to possibly make a difference. I agree with some things, but not others. Right now I am just trying to be as supportive as possible.

 

Thanks again for all the great information.

[Cliffee]

I started on Gleevac and eventually switched to Tasigna for a better response. I was on Gleevac for 22 months.

 

With Gleevac I had occasional nasty muscle cramps and serious puffiness around the eyes.

 

With Tasigna I don't even know I'm taking it. Really amazing! Seemed to give me a better response so far as well. Starting to plateau right around MMR after 12 months. Hoping this is temporary and will start heading down more soon.

[tinman1939]

I was on Gleevec for seven years before switching TKIs. While on Gleevec, there were months that I never thought (much) of my condition, so it was a bittersweet goodbye when I started showing some resistance to it late last year, as well as some mutations.

 

Since then, I had a bad reaction to Sprycel after only a few days, some unappealing side effects with Tasigna (another short couple of weeks or so), but am now in month four of Iclusig (Ponatinib).I seem to be managing this TKI well, and it is definitely effective.  My BCR/ABL went from 56% to 16% in three months with only 15 mg/day.  I am now on 30mg/day and hope to achieve a major cytogenetic response (or better) by the next BCR/ABL test in a few months.

 

Good luck on your CML journey.

[Trey]

RM,

Just a hint.  Having a discussion with transplant doctors requires a bit of perspective.  They think a transplant is a reasonable therapy, since that is what they do; otherwise they would not be in that business.  But transplant is not a good idea for most CML patients who can do well on TKI drug therapy.  The hazards of the transplant process (docs minimize the risks) and the long term damage to the body (autoimmune issues, sterility, and secondary cancer risks) are significant issues.

 

http://community.lls...ics +transplant

[NotJack?]

What Trey said!