2 replies to this topic

[donnadavis]

I  am  kind  of  on  hold  right  now  waiting  for  the  powers  that  be to  decide  what  drug  will  be  next.  I   have  been  on  Gleevec  and  Tasigna  and  my  levels  are  rising  again.  I  had  a  mutation  test  between  the  Gleevec  and  the  Tasigna  and  there  were  no  mutations. My question  is  why  are  these  drugs  not  working? Is  CML  all  the  same   except  for  the  type  with  a  mutation  or  are  there different  levels  that  are  harder  to  deal  with. Does  this  make  any  sense?  I  am  just  looking  for  a  reason  I  guess. If  my  CML   has  no  mutation  why  won't  it  respond?

[Trey]

A kinase mutation is less likely to be the cause of poor drug response than other factors.  Other factors include: 1) poor cell uptake of drugs (some have better uptake than others), and sometimes increased dosage can help; 2) over-expression of LYN; I know, it is a technical issue, but this can inhibit TKI drug action.  Sprycel can overcome this issue better than the others since it inhibits SRC, and LYN is a subset of SRC.  It is a three-beer discussion, and I don't have three beers in me right now....  3) other factors that are not well understood.

So rather than speculate on what might not happen, switch to Sprycel and see if it works.

[donnadavis]

Thank you Trey. That is what I have requested.