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Sprycel - five year results


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#1 scuba

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Posted 23 May 2016 - 07:37 PM

http://www.cancernet...satinib-use-cml

 

Notably, drug-related pleural effusion was more common with dasatinib, occurring in 28% compared with 0.8% of imatinib patients. The authors noted that pleural effusion did not impair patients' ability to obtain a response. 

 

"These results suggest that first-line dasatinib should continue to be considered a standard first-line therapy for patients with newly diagnosed chronic phase CML," the authors concluded, adding that other randomized studies have confirmed the benefit of dasatinib as well.

 
 
 
 

 


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

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

 

Sprycel: 20 mg per day - taken at lights out with Quercetin and/or Magnesium Taurate

6-8 grams Curcumin C3 complex.

 

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 Gail's

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Posted 24 May 2016 - 12:59 PM

Gleevec was so tough on me and didn't bring my numbers down quickly enough. Sprycel did knock my pcr down quickly and side effects different, better, but I'm hating this lung irritation, dry cough and short of breath. Good to know I'm not alone.
Diagnosed 1/15/15
FISH 92%
BMB 9:22 translocation
1/19/15 began 400 mg gleevec
1/22/15 bcr 37.2 IS
2/6/15 bcr 12.5 IS
3/26/15 bcr 10.3 IS
6/29/15 bcr 7.5 IS
9/24/15 bcr 0.8 IS
1/4/16 bcr 0.3 IS
Started 100 mg dasatinib, mutation analysis negative
4/20/16 bcr 0.03 IS
8/8/16 bcr 0.007 IS
12/6/16 bcr 0.002 IS
Lowered dasatinib to 70 mg
4/10/17 bcr 0.001 IS
Lowered dasatinib to 50 mg
7/5/17 bcr 0.004 IS
8/10/17 bcr 0.001. Stopped TKI in prep for September surgery.
9/10/17 bcr 0.006
10/10/17 bcr 0.088

#3 JPD

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Posted 26 May 2016 - 12:44 AM

Ugh.  If I dont get lower that .10 this test (see below) Im gonna switch.


January 15: .53%

April 15:       .78%

July 15:      1.1% - upped dosage to 400mg after this test

Oct 15:       .85%

December 15:  .28%

March 16: .29%

July 16: .34%

October 16: .11%

January 17: .081%

April 17: .055%

July 17: .135%

Oct 17: .008%


#4 jlegakis

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Posted 28 May 2016 - 03:40 PM

I have not had a quick response on 3 mos. with Sprycel at 100mg. at all. I had a retest and it came up yesterday at 57% after a previous 54% 3 wks. earlier.I was on Gleevec for a year and a half and reached 4% Pcr and 0% FISH, but I became resistant to the 600mg. and my onc switched me to 100mg. Sprycel in Feb.-3 mos. ago and my numbers are steady , but slightly creeping up! In fact, when I went off Gleevec my Pcr was at 27%. So, I am confused! My onc wants to keep me with 100 mg. Sprycel until the end of July which will be the 6month mark he claims is the prescribed time protocol to see IF Sprycel will eventually bring my Pcr down. Should I have a mutation test BEFORE that since I had one about 9 mos. ago with nothing showing.Am I at a so-called plateau and should be patient? Does Sprycel sometimes work slowly?My numbers also came down VERY SLOWLY with Gleevec as well, but I did eventually hit CCyr. What should I do? Should I get another Pcr in June to more closely track my BCR/ ?Or, should I wait until the end of July?

#5 Gail's

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Posted 29 May 2016 - 02:12 PM

You should see another oncologist. Preferably consult with one of the CML specialists like Druker in Portland Oregon. There are others too all over the country that are experts. I don't feel like your onc is even following national guidelines.
Diagnosed 1/15/15
FISH 92%
BMB 9:22 translocation
1/19/15 began 400 mg gleevec
1/22/15 bcr 37.2 IS
2/6/15 bcr 12.5 IS
3/26/15 bcr 10.3 IS
6/29/15 bcr 7.5 IS
9/24/15 bcr 0.8 IS
1/4/16 bcr 0.3 IS
Started 100 mg dasatinib, mutation analysis negative
4/20/16 bcr 0.03 IS
8/8/16 bcr 0.007 IS
12/6/16 bcr 0.002 IS
Lowered dasatinib to 70 mg
4/10/17 bcr 0.001 IS
Lowered dasatinib to 50 mg
7/5/17 bcr 0.004 IS
8/10/17 bcr 0.001. Stopped TKI in prep for September surgery.
9/10/17 bcr 0.006
10/10/17 bcr 0.088

#6 Trey

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Posted 07 June 2016 - 02:58 PM

I have not had a quick response on 3 mos. with Sprycel at 100mg. at all. I had a retest and it came up yesterday at 57% after a previous 54%

 

Since you only ever achieved a brief CCyR, and now have lost that CCyR fairly rapidly, I would have a BMB done.  I would also ask for another mutation test as a precaution.  Those results on Sprycel are not as expected.  A PCR would be done with the BMB, and if no progress then another drug switch would be required (Tasigna or Bosulif).  The Sprycel should have worked rather quickly if it was going to. 



#7 jlegakis

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Posted 09 June 2016 - 04:00 PM

Thanks to you all! I want to add that despite a rise in my PCR from 27% on Gleevec(600mg.)after 18 mos. to 54% on Sprycel(100mg.)after ONLY 3mos. my CBCis stable:White blood cells at 5.1,HGB at 14.0 and Platelets at 95.I will get a mutation test in July if my PCR does NOT go down and ,PERHAPS, a BMB too .Does a TKI sometimes take longer than 3 mos. to take effect? Is it possible that my body might need extra time to actually start working on Sprycel? Where do you draw the line and determine that a particular TKI is NOT working? At 3mos.? Or, at 6mos.? Am I in danger of going into an accelerated phase of CML if I don`t act soon? My PCR also went down very slowly on Gleevec as well,so maybe I am a turtle as the discussion boards have stated?? I feel good and jog 3-5 miles a day and have had no side- effects on Sprycel, so I am  awating a PCR in a few weeks! My thought is that I may be at a PLATEAU ?I am in a hematolgic remission so is there any need to panic? I am anxious though! I would appreciate any advice-for sure! Thanx again to all of you folks! This upcoming PCR will mark me as being on Sprycel for 6MOS-. a crucial time for sure.I have already sent my medical records to a CML specialist for a second opinion regardless. Am I on the right track??



#8 Gail's

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Posted 09 June 2016 - 04:45 PM

Jlegakis, what does your onc want you to do? I think Trey's advice is sound. If you have a mutation, you will need to get on a different more effective treatment.
Diagnosed 1/15/15
FISH 92%
BMB 9:22 translocation
1/19/15 began 400 mg gleevec
1/22/15 bcr 37.2 IS
2/6/15 bcr 12.5 IS
3/26/15 bcr 10.3 IS
6/29/15 bcr 7.5 IS
9/24/15 bcr 0.8 IS
1/4/16 bcr 0.3 IS
Started 100 mg dasatinib, mutation analysis negative
4/20/16 bcr 0.03 IS
8/8/16 bcr 0.007 IS
12/6/16 bcr 0.002 IS
Lowered dasatinib to 70 mg
4/10/17 bcr 0.001 IS
Lowered dasatinib to 50 mg
7/5/17 bcr 0.004 IS
8/10/17 bcr 0.001. Stopped TKI in prep for September surgery.
9/10/17 bcr 0.006
10/10/17 bcr 0.088

#9 Trey

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Posted 12 June 2016 - 08:57 AM

If the upcoming PCR does not show good improvement I would do the BMB and mutation test.  Also, I would switch from PCRs to FISH since you are above CCyR (or do both PCR and FISH).






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