6 replies to this topic

[TeddyB]

http://www.nature.co...leu201545a.html

 

"In conclusion, an IFN/imatinib induction treatment followed by a temporary IFN maintenance therapy may enable a high rate of treatment discontinuation in CML patients in at least MMR when stopping imatinib."

 

Could someone please explain the term: IFN maintenance therapy?

How often would one take this Interferon Alpha 2a?

The side effects look pretty awful: http://www.drugs.com...de-effects.html

 

[Trey]

A disingenuous conclusion IMHO.  If you only count those who have stopped all therapy, only 9 of 20 (45%) remain PCRU without continuing IFN therapy.  Same as without IFN, pre-treatment or otherwise.

 

I also don't trust small studies like this one with only 20 patients.  A change in one patient swings the percentages by a large margin.

 

IFN maintenance therapy means you stop the TKI and continue with low dose IFN.  Side effects are less than full IFN therapy as in the old days.   

[jjg]

TeddyB - I'm guessing you can't see the whole article? The interferon doses were:

First-line therapy in this cohort consisted of a combination of imatinib (400 mg p.o. daily) and concomitant subcutaneous injections of either recombinant IFN (3-5 injections × 3-5 Mio. IU weekly) or 90-135 μg pegylated IFNα2a (Pegasys, Roche, Basel, Switzerland) once every 1 to 3 weeks according to efficacy and tolerability

 Low-dose IFN maintenance therapy consisted of Peg-IFN2a at a median dose of 135μg every 4 weeks (range, 135 mg every 2-12 weeks) (n=17), or IFN 2 to 4 × 3 Mill IU IFN/week (n=3)

 

I was on IFN which is supposed to have worse side effects then the pegylated version. I started with 3.5 M IU 3x a week and built up to 3.5 M IU daily - only had a response when it was at the final dose. Side effects were not good but you do develop a tolerance for most of them. I was scaling up the dosage so that the side effects remained at a tolerable (just) level i.e. initially the 3x per week dose generated a similar level of side effects as the daily dose generated 2 months later.

 

While not quite what this research was looking at the result is interesting for those who might need to go off TKIs (e.g. for pregnancy) after having had a good treatment response. I don't think much work has been done on treating people in MMR with interferon to see if interferon can maintain the MMR. Obviously a small trial so the statistics can only ever prove/justify the need for more research, however those patients were followed for a long time and it is a very good journal.

[Billie Murawski]

I cannot understand how a person could agree to taking such a drug. If all the tkis stopped working for me I would not want to be in any kind of new trial, I would let nature take its course. Quality of life is more important for as long as we have it. Just my 2cents.

                                               Billie

[gerry]

I remember talking with someone on a forum about going on a trial of INF and Gleevec, my doc was surprised that they were in a trial for this  when I mentioned it to him.

[jjg]

Billie I understand what you are saying but if you read the text: "The four patients who currently still administer IFN every 4-12 weeks do so upon own request." 

I actually suspect that at that low dose the interferon is not too bad for those who have built up tolerance over a long time.

For me 800mg Glivec was as life destroying as interferon (600mg glivec was also pretty awful). I'm extremely grateful for tasigna. Because of that I don't really understand why some people stick to glivec when they have bad side effects and less than optimum results. I guess sticking to interferon is following the same logic.

[TeddyB]

jjg: correct, i could only see the abstract.

 

In the Euroski study, the stopping success rate was high for those who had been on TKI`s for 8 years +, "only" 26% relapsed, this sounds better than going off and on IFN, but who knows, im no expert