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Paradigm Shift in CML Highlights Need for Accurate Molecular Monitoring

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#1 scuba


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Posted 14 January 2016 - 05:12 PM

It seems that a divergence of care is occurring between the academic centers of excellence where clnical trial are conducted and community practices. We read here on the forum how so many patients are not getting the treatment protocol - especially the testing - that is needed for proper follow-up and care. The link below highlights the issue. 


There is debate - in general, clinical trial outcomes are being mirrored out in the community (where most patients are treated). That is good, but it is still disquieting that clinical practice in many cases are not being followed when advances in treatment can be available.





According to Elias J. Jabbour, MD, associate professor at MD Anderson Cancer Center in Houston, and a senior author on the study, "If the patient has the test done at a center of excellence, the results should be communicated to the community doctor, because if they are not responding very well, maybe the doctor can change the drug. But if the test results are not communicated, that means the physician cannot act. It doesn't matter where the test is done, if the doctor is not acting on it. Monitoring in academic centers is great, but in the community, patients are not getting good monitoring," Jabbour contended. "We need to have another study." - See more at: http://www.targetedo...h.rmuB6fY8.dpuf

Diagnosed 11 May 2011 (100% FiSH, 155% PCR)

with b2a2 BCR-ABL fusion transcript coding for the 210kDa BCR-ABL protein


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2015 PCR: < 0.01% (M.D. Anderson scale)

2016 PCR: < 0.01% (M.D. Anderson scale) 

March        2017 PCR:     0.01% (M.D. Anderson scale)

June          2017 PCR:     "undetected"

September 2017 PCR:     "undetected"

#2 houtex54


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Posted 16 January 2016 - 01:38 PM

Good point about monitoring and sharing of results being needed for ongoing management of the treatment program.  Monitoring of progress is also essential to making a decision to discontinue TKI treatment or not.   The rapidity and depth of the initial response and duration of a deep response are both necessary elements in this decision.  

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