Switching a TKI (Gleevec) for CML not in remission – pro
Early identification of patients who are unlikely to achieve optimal responses is important for improving long-term outcomes with TKI therapy. CyRs have been used to guide treatment decisions, and emerging data suggest that molecular responses may also provide an early indication of treatment failure or success. The ELN (European) Guidelines, but not the NCCN Guidelines, include an MMR milestone to guide treatment decisions. NCCN recommends continuing the same TKI agent if BCR-ABL si less than 1%, adm a workup, of more.
David Rizzieri MD, Implementation of Management Guidelines For Chronic Myeloid Leukemia Perspectives in the United States. P T. 2012;37(11):
NCCN, CML-3 2018.
Thomas O’Hare et al, A Decade of Nilotinib and Dasatinib: From In Vitro Studies to First-Line Tyrosine Kinase Inhibitors Cancer Research October 2016 Volume 76, Issue 20