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Cost, adherence as vital as TKI choice for CML

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#1 Buzzm1


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Posted 09 December 2015 - 12:55 AM

Cost, adherence as vital as TKI choice for CML http://managedhealth...-tki-choice-cml
Second-generation tyrosine kinase inhibitors (TKIs) available for frontline and second-line treatment of chronic myeloid leukemia (CML), like nilotinib and dasatinib, clearly show "better, earlier" major molecular responses for patients with CML than earlier drugs such as imatinib (Gleevec),
second-generation drugs are more potent,"but It is not yet clear if that translates to longer survival for patients, however.
Side-Effects ... A more troubling possible side-effect has also emerged over recent years: cardiovascular events.

"This is a warning to know patients' comorbidities when they walk in the door," Larson said. "Because these cardiovascular comorbidities may prove to be more life-threatening than their leukemia."


Current formulary prices for TKIs used in frontline or second-line CML treatment all exceed $130,000 a year per patient, he noted — and ponatinib, a second-line TKI for CML, exceeds $160,000 a year.

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


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 BlogStopping - The OddsStop Studies - Discussion Forum Cessation Study

Big PhRMA - Medicare Status - Social Security Status - Deficit/Debt

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