Posted 10 January 2016 - 10:07 AM
From the STOP studies http://bit.ly/1XyGyL5: there are a lot of variables, but after two years PCRU ...
the average odds of successfully stopping are 50/50 and while there are no absolute guarantees, TKI response, and duration of response, do add to the odds of remaining TKI-free
At least one of the STOP studies stated that almost all, out of those who relapse (relapse is defined as losing MMR), do so within the first four months.
All STOP studies state that almost all who relapse, lose MMR, do so within the first six months.
A number of people in the studies lose PCRU, but don't lose MMR.
Relapse beyond six months is a very low percentage.
With second generation TKI's, the odds of successfully ceasing TKI treatment after just one year PCRU, aren't that much less than after two years PCRU
Dasatinib Discontinuation trial http://bit.ly/1liFp8M November 9, 2015
from an initial 63 with confirmed deep molecular response for at least 1 year
after 6 months, 31 (49%) treatment free
after 20 months, 30 (47.6%) still treatment free
52 patients required prior 2nd generation TKI treatment (Dasatinib, Nilotinib, Bosutinib) with a median of 6.5 years of TKI treatment and a median duration of MR4.5 of 2.3 years ...
28 of 52 (54%) remained treatment free
For the benefit of yourself and others please add your CML history into your Signature
02/2010 Gleevec 400mg
2011 Two weakly positives, PCRU, weakly positive
2012 PCRU, PCRU, PCRU, PCRU
2013 PCRU, PCRU, PCRU, weakly positive
2014 PCRU, PCRU, PCRU, PCRU (12/07 began dose reduction w/each continuing PCRU)
2015 300, 250, 200, 150
2016 100, 50/100, 100, 10/17 TFR
2017 01/17 TFR, 04/18 TFR, 07/18 TFR 0.0012, 08/29 TFR 0.001, 10/17 TFR 0.000
2018 01/16 TFR 0.0004 ... next quarterly PCR 04/17
At the earliest opportunity, and whenever possible, lower your TKI dosage; TKIs are toxic drugs and the less we take longterm the better off we are going to be ... this is especially true for older adults.
In hindsight I should have started my dosage reduction two years earlier; it might have helped minimize some of the longterm cumulative toxic effects of TKIs that I am beset with.
longterm side-effects Peripheral Artery Disease - legs (it's a bitch); continuing shoulder problems, right elbow inflammation. GFR and creatinine vastly improved after stopping Gleevec.
Cumulative Gleevec dosage estimated at 830 grams
Taking Gleevec 400mg an hour after my largest meal of the day helped eliminate the nausea that Gleevec is notorious for.
Trey's CML Blog - Stopping - The Odds - Stop Studies - Discussion Forum Cessation Study
Big PhRMA - Medicare Status - Social Security Status - Deficit/Debt