Nice summary of current thinking in CML treatment:
from the article:
"The most important goal of therapy "is the prevention of progression to accelerated phase and blast crisis," stressed Erba. "It's really important for the community oncologist to know that when we're talking about progression, we're not talking about losing a response and the white count goes up again."
Rather, Erba said, "progression means that the biology of the disease has changed. The outcome of these patients is worse. Their survival is worse. They're facing decisions about allogeneic transplant in that position, and when patients progress to accelerated phase or blast crisis, their median survival is about 10 months, So prevention of progression becomes the most important goal in my book, and treating patients with an agent that they can tolerate to do that is important." Two large randomized controlled trials have shown that second-generation TKIs have fewer progressions to accelerated- or blast-phase disease compared with imatinib".
This caught my eye:
"Although there has been discussion about whether selected patients might be permitted to discontinue pharmacotherapy, at present and outside of clinical trials the word on TKI discontinuation is "don't try this at home," said Pinilla-Ibarz. Of course, the situation might be different if a patient wants to become pregnant. In that situation, Kelly might discontinue but first "would like to see a complete molecular response that's sustained preferably over a 2-year period." Thereafter, he would monitor "very carefully" because "they can relapse—even late after discontinuation— with lymphoid blast crisis.""
- See more at: http://www.onclive.c...h.1FloDLWT.dpuf