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Combination Therapy Shows Promise For Chronic Myloid Leukemia

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#1 gerry


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Posted 04 September 2017 - 05:26 PM


#2 kat73


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Posted 05 September 2017 - 09:59 AM

What is currently happening with this?

Dx July 2009 on routine physical.  WBC 94.  Started Gleevec 400 mg Sept 2009.  MMR at 2yrs.  Side effects (malaise, depression/anxiety, fatigue, nausea, periorbital edema) never improved.  Kidney issues developed because of Gleevec.  Switched to Sprycel 70 mg in Aug 2011.  Above side effects disappeared or improved.  Have been MR3.5 - 4.5 ever since.  Two untreated pleural effusions followed by one treated by stopping Sprycel Jan 2017.  After 9 weeks, PCR showed loss of MMR; re-started Sprycel at 50 mg and in 3 months was back to <0.01% IS.  Pleural effusion returned within a couple of months, same as before (moderate, left side only).  Stopped Sprycel 50 mg for 12 weeks; pleural effusion resolved.  At about a monthoff the drug, PCR was 0.03; at 11 weeks it was 2.06 - lost CCyR? Have returned to 50 mg Sprycel for 3 weeks, intending to reduce to 20 mg going forward.

#3 gerry


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Posted 05 September 2017 - 05:12 PM

Bit more detail, but still early days on it https://www.ncbi.nlm...86/#!po=33.4951

#4 gerry


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Posted 05 September 2017 - 05:17 PM

They are using the Venetoclax with the CLL drug Rituximab and have had some good results in CLL patients. http://www.cancerthe...article/631455/
No information on human trials of it with one of our TKIs that I can see yet.



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Posted 05 September 2017 - 06:39 PM

In talking with people involved in research and development (R&D) of new
drugs the processes goes along 4-stages.
First... dose it work in lab and mouse trials. Can this be duplicated with
independent peer review. If so.. And does it do what it suppose to do  and
don't kill the animal. Or make them sicker. This is the independent labs
work. They do this work for sale. The first step.
Second...it goes to human trial. Now these are people that have nothing to
loose. Everything  else has not worked and they are on their last chance.
If it works to a statistical measure and if found it doesn't kill anybody. It
goes to a larger human trial. Many drugs go back to the drawing board if
these results are not good.
Third...These are people that are good candidates as per the criteria or
scope of the objective of this therapy intends to treat. The end goal has a
tendencies to modify as the trials progresses. It starts out being a wonder
drug and ends up curing some headache in certain people.
The second and third human trials are frequently funded by government.
If all is well and the drug has been defined as a treatment for whatever
and generally safe it gets approved for general use.
This whole process from the purchase of the patent from the lab takes
about five years. If all goes well.
It's here the drug company sends out the salesmen to peddle the drug and
you see it on the TV suggesting to ask your DR to give it to you.
A little known fact is that drug companies don't do R&D anymore. They
send out talent scouts to all the independent labs and research
labs and buy already proven murine (mouse) and invitro (petri or testube)
results. Then they replicate it themselves and they patent the molecule.
Then go to the government for the second and third human trials. Get the
grant money and take it from there. So when they say that the reason for
the high price is because of all the R&D they had to do it's not really true.
They bought it already done. The drug companies can advertise and
distribute it where as the lab that did the R&D can't. 
With technology as improved as it is today small independent research
labs can do incredible breakthroughs and mostly do this work with the
intent to sell their findings to the next level as they can't market and
distribute the product as good as the big drug companies.
The rags to riches story where the guy discovers some new invention and
gets the patent and sells it to all the world and owns it from start to finish
doesn't work in todays complex society. 
They will try this first on very sick people if it goes further.

DX August 2016. WBC ~160K
PH+ Cells 36%
No Spleen enlargement
No Symptoms. Other counts ~Normal
BCR-ABL p210 (Detected)
BCR-ABL p190 (Not Detected)
Sprycel 100mg.
PCR   02/01/2017    0.146 IS
PCR   08/07/2017    0.022 IS
Next PCR:           12/XX/2017

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