The Leukemia & Lymphoma Society - Fighting Blood Cancers
42 Replies Latest reply: Mar 15, 2012 9:03 AM by pammartin RSS

Swiching Meds

Badger Registered Users
Currently Being Moderated

There's a possibility that I may be switching from Sprycel to Tasigna.  Can anyone shed any light on what process to follow to avoid potential problems?  When I switched from Gleevec to Sprycel, my Onc just had me start Sprycel the day after taking my last Gleevec—wasn't a good idea!

  • Re: Swiching Meds
    hannibellemo Registered Users
    Currently Being Moderated

    I'm always amazed when I hear docs doing that to their patients! As long as you aren't needing to wait for something to resolve itself, like liver issues, PE, etc. you should be ok after a week or so. I'd probably go for the "or so" if I could get away with it just so I could get a taste of feeling good again!

     

    Good luck!

     

    Pat

  • Re: Swiching Meds
    Headi Registered Users
    Currently Being Moderated

    My onc has suggeted that I will also be going to Tasigna from Sprycel at the end of March.  I paid attention to advise from folks on this blog and took a weeks vacation before going to Sprcel.  The transition was very easy. I tolerated it much better than Glevec. I am a bit worried about going to Tasigna as i'm tolerating Sprycel very well. Would be very interested in how you end up handling it, Badger. I would also love to hear from some who have already gone through the transition to Tasigna and some information on what to expect. I don't know f this is any help to you, but I'm leaning towards a week of no meds unless someone can advise if & why this would be a mistake. Thanks to all

    • Re: Swiching Meds
      Sneezy12 Registered Users
      Currently Being Moderated

      Why are you switching? Frank

      • Re: Swiching Meds
        Headi Registered Users
        Currently Being Moderated

        My understanding is that I have not gotten to PCRU yet although my numbers have been going down with every PCU done. I was diagnosed in June 2009 and started on Glevec in July. The side effects were difficult and never seemed to get better, so my Onc put me on Sprycel in Dec 2011. I tolerated the Sprycel much better and it seems to be working, but perhaps not quick enough for my Onc. He is the one that suggested going to Tasigna after my next PCR at the end of March if i'm not in remission by then. My last PCR was done in Nov. 2011. My white count has continued to be normal since then. I'm not anxious to go on a new med when i am feeling good on the one I'm on.

        • Re: Swiching Meds
          hannibellemo Registered Users
          Currently Being Moderated

          Headi,

           

          The majority of us may never see PCRU and in my opinion that should not be the cake but the icing on the cake. What you need to be looking for, the cake, is CCyR (Complete Cytogenic Response) about a 2 log reduction or .2% on the International scale (IS) or zero FISH and MMR (Major Molecular Response) about a 3 log reduction or .1% on the IS. Sprycel is working just fine for you if you have reached a minimum of CCyR and even better at MMR. Guidelines indicate we should be at least CCyR by 18 months, preferably MMR by then.

           

          Remission is not generally a term used with CML since we continue to have, even at PCRU, leukemic cells in our blood.

           

          Please feel free to post your most recent results and someone will be able to tell you exactly where you stand with your tests.

           

          Good luck!

           

          Pat

        • Re: Swiching Meds
          CallMeLucky Registered Users
          Currently Being Moderated

          Headi - exactly what does your doctor consider "remission"?

           

          I ask because most of the top CML doctors would tell you there is no such thing as remission in CML treatment.  You have varying levels of response.  Not to get into semantics but when I hear a doctor insisting that the patient should achieve a "remission" it makes me think they may not be fully up to speed on how CML is treated and monitored.

           

          Let's assume your doctor is considering "remission" to mean when your PCR is negative.  What does that mean?  You should discuss with your doctor and find out what he thinks on this topic.  For instance it would be good to know if he is aware that a negative PCR score does not mean you have no more leukemia in your system.  Would also be good to know if he knows the sensitivity of the lab performing the test and if your sample was sent to another lab with more sensitive equipment your results could vary greatly.

           

          My point is that some doctors are hell bent on getting you to zero because it makes them feel good (and maybe it helps you psychologically) but should you go through the risk of changing drugs just for the illusion of a remission that is not really there?  If the lab only tracks to a 4 log reduction and it shows negative but if you sent it to a lab that did a 4.5 log reduction cut off does your doctor think there is much of a difference between .0000 and .00001?

           

          The issue at hand here is that your doctor appears willing to change your treatment option that is working well for you to see something on a test that is not accurate enough to answer the question he really asking.  I think you as the patient should understand if he knows this and then decide if changing drugs is what is best for you.

           

          You haven't stated what your level of response is, but if you are greater than a 3 log reduction (i.e. major molecular response) and you are doing well on Sprycel, you may want to give it some time rather than chancing a change to another drug that you do not know how it is going to affect you.

          • Re: Swiching Meds
            Headi Registered Users
            Currently Being Moderated

            Thanks so much for the response to my questions. I don't really know how to read my lab results, so I will do as suggested by Pam and post them. This is what is listed Under results: BCR/ABL1: DETECTED, under that is BCR/ABL1 of b2a2 Type: 0.68%

               BCR/ABL 1 of b3a2 Type: Not detected

               BCR/ABL 1 ofe1a2 Type: Not detected.  The only thing I know about this is that every time I have had a PCR done the line goes lower on the chart and the percentage is less than the time before. I have been following the posts here on and off for possibly a year or so without saying much, but just following the chatter has been very helpful in many ways. I was not unhappy to get off Gleevec, so I didn't challenge the dr. on that, but now I'm not sure about changing so I need to know why.  When I was diagnosed with CML my Onc. said you are lucky, you have the type of leukemia that can be treated and maybe even cured, so just take these pills and go live a normal life??? Thats about all the understanding of the disease I got from him. All my learning has come from this blog, so I thank you all. (I have copies of postings from Trey in my medical files which have helped me to understand some of the terminology as well as the tests : )  I have written down the questons from Hannibellemo and call me lucky and will bring them with me to next apt. I will be very grateful If anyone can explain these test results. Thank you again.

            • Re: Swiching Meds
              Trey Registered Users
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              The key issue in response to drug therapy is a continually declining PCR result (although not always fast or in a straight line).  You describe a "good" response.  Your PCR numbers are best compared to the results before them, not to how others responded.  Although there is a small chance that Tasigna would provide a better response, there is also a chance that it would not be any better, or maybe even not as good.  Many Oncs might switch the patient from Gleevec to another drug if the response is somewhat slow, but would stick with either Sprycel or Tasigna if they are working "well enough".  Trying to attain "better" when you already have "good" goes beyond both the science and understanding of these drugs.  If you want to stay with Sprycel, that seems a reasonable choice.  If you want to try Tasigna, there is nothing inherently wrong with that, but it might not accelerate the PCR decline.  However, if you do switch you could always return to Sprycel, since as long as a drug works for someone they can always return to it. 

              • Re: Swiching Meds
                Headi Registered Users
                Currently Being Moderated

                This is very good news to me, as I was not sure if my response was considered good especially since my dr. was talking about me switching meds again. I did make one mistake in my post. I said I started Sprycel in Dec. 2011.  That was a typo, I started it in Dec 2010.  I hope that doesn't change things.  The response has been a little slower on Sprycel than on Gleevec, but as I said its so much easier on me as far as side effects go and I would like to give it a little more time.

                Thank you for your input, Trey. I respect what you say. That along with others who have offered suggestions has put me in a better place to come to a decision on this if I have to. 

                • Re: Swiching Meds
                  Trey Registered Users
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                  It is also useful to understand that drug response can often reach a plateau and remain somewhat level for a while before heading down again.  This seems to occur about the 1 -2 year point in the treatment cycle.  I think the lack of experience with these drugs by most Oncs causes them to have unrealistic expectations about a straight line drug response.  The early fast response is the drug killing off the easy-to-kill lower level leukemic cells.  Then the drug must work up the chain of higher level leukemic cells, and they are harder to kill the higher they are in the chain.  This causes the response to appear to slow down, although in reality the drug is preventing the higher level leukemic cells from proliferating into the lower level leukemic cells. 

                  • Re: Swiching Meds
                    Judy2 Registered Users
                    Currently Being Moderated

                    Hi Trey,

                     

                    Do you think it is important for all of  us to reach MMR or can we live with a higher PCR and still not risk the disease progressing or a mutation developing? If that is the case, what do you thnk that level could be? Thanks if advance.

                     

                    Judy

                    • Re: Swiching Meds
                      pamsouth Registered Users
                      Currently Being Moderated

                      Hi Judy,

                       

                      I would like to hear Treys answer to that as well.  I did search for one of his websites, which answers it pretty good.

                      http://community.lls.org/docs/DOC-1276    

                       

                      This was one of the discussion I had last November when I went to the CML expert for a second opinion or consolation.

                       

                      He drew his little diagram on the board, like they do, when you are going for a consultation, you  know explaining the CHR, CCR, MMR.  After he got done drawing, he said "I don’t care if you stay in the middle here as long as you don’t have an upward trend, where it looks like you are losing your response to G"  If it continuously goes up, then we would have to do some testing, and see what the problem is.

                       

                      I can see by Trey’s web, that supposing the deeper the response the better chance of longer survival.  However I noticed in the middle it said something about being just being stable as be good to.

                      I was impressed when he the oncologist said he didn’t go by guidelines, like my former onc did. 

                       

                      My grip about this deep response thing is.  You got to have some quality of life, or what is the sense of it all!  So as long as I reach a happy stable medium I don’t care if it is not an MMR.  Yes some people do well with the TKI and quality of life, but other do not.  I think Trey only has to take 200 mg of G and I think Scuba only takes 20mg of Sprycel, now how many can take that low of a dose and still have a good response?

                       

                      I mean if I get this right in my head even if you had an MMR which means the TKI are killing more cells, you still have millions of leukemia cells that something can still go wrong.  Maybe not as many bad cells as an MMR then if you had an CCR.  That is all I really care about is have a good FISH report that is between 92 % and 100 % negative.  I mean these PCR have so much room for error, even both onc admitted that. 

                       

                      So I would just be happy to stay in the middle somewhere and be able to live somewhat a normal life, without being sick everyday with rashes and headaches and fluids, etc.

                       

                      PamSouth

                    • Re: Swiching Meds
                      scuba Registered Users
                      Currently Being Moderated

                      Hi Judy,

                       

                      An excellent prognosis is associated with a deep PCR response of 3 log or more drop* below your baseline coupled with complete cytogenetics remission in 12 to 18 months from start of continuous therapy. I was also told by Dr. Cortes that if a patient re-starts therapy with a new drug, he starts the clock over meaning a new baseline and timeline for response with that new drug.

                       

                      There are exceptions to this general data observation. Many patients do well with no progression of disease with PCR log response lower than reported (i.e. 2 log response or PCR that goes up and down). But it is very important that Cytogenetics show no Ph+ chromosomes. That is most important in prognosis. Everyone wants to get their FISH to zero as quickly as possible. Durability of this is indicated by how fast PCR falls along side.

                       

                      p.s. * A 3 log drop is typically from 100% PCR through to 10%, then 1% then .1% (hence the 3 log drop). 0.1% PCR sets the benchmark for MMR (major molecular response). So if someone had a baseline PCR of 155% - then the 3 log indicator for MMR would be 0.15%. Personally - this is all fuzzy math since PCR is such a problematic test. What's important is that the PCR drops to below 1 and either keeps dropping or stays there while cytogenetics = zero. All I care about is that I have zero's to the right of the decimal point in my PCR report. If my PCR goes up by more than one log, then I will have a bone marrow cytogenetics test done.

                      • Re: Swiching Meds
                        Judy2 Registered Users
                        Currently Being Moderated

                        Thanks Scuba and Pam South,

                         

                        I understand it better now.  I started my third TKI 2 months ago so in a sense I guess it's like I'm at the beginning of treatment again. I had heard that how you do in the first 3 months of treatment is an indicator of  your long term prognosis but since we now have 3 TKIs I'm assuming this is no longer the case. The other thing I think about is this. Since with CML we do not have solid tumors, like other cancers, we have the PCR tests instead of, say, an MRI to see if we have cancerous cells in our body. If someone had a solid tumor cancer and their MRI showed even a tiny tumor the onc. would consider this as less than favorable. In that case the person would have to continue their chemo regimen indefinitely as we have to continue ours. When I think of it this way I wonder how long can our medicine overcome this? I know statistics say 30 years but no one has been on the medicine for 30 years so how do the researchers know this? If our body is continually churning out these cancerous cells how good that that be for us? It seems like it would eventually compromise our health in other ways, you know, wear our body down. Any thoughts on this?

                         

                        Judy

                        • Re: Swiching Meds
                          pamsouth Registered Users
                          Currently Being Moderated

                          Judy2. 

                           

                          Those your thoughts have been my thoughts from day one.  These are new drugs. It is not like they have been studied like 10-15-20 years, like other patents are before they become generic.  I think Sprycel with trial in 2007 and patent in 2009 not sure, Of course it is with good reason, in that we need these new drugs now, so the history data is not in!  I think it would be fair to say we are somewhat the guinea pig.

                           

                          I would venture to guess in answer to your question about living 30 years.  That would be the hope that the drug companies would keep new drugs coming along, so if one failed another one would work. 

                           

                          Yes I do agree with you, basically who know the medium, long term effects.  I am sure it will become an individual thing in the end or ongoing  studies.  Ex; some people on this board have been on Gleevec since it went to trial in 1997, (thus more data, although I do thinking sometimes, they are pushing patients, on to the newer TKI's before G loses it’s patent, need research money and patients for research as CML is rare). I don’t know the latest percent still on Gleevec, but a lot of them, I think, are still doing good, I don’t really know, maybe I should google it.  Your question, For how long, 30 years, what if G doesn’t work, how will the other drugs work, and how long, what quality of life.  etc. The Unknown, They don’t know they are new drugs!!

                          I think lots of onc playing the guessing game, trial and error.

                           

                          I think the big concern among scientist and the drug makers is the side effects and the quality of life.  How deep of a response can we get and still not damage are 5 organs and still not have serious side effects from the toxicity and have a quality of life.

                           

                          These drugs only kill the PH+ at the lower level.  We are not killing the ancient bad mother stem cell.  I hear she can live for a long time.  I believe I read from one of Treys blogs, that she goes into hiding up close to the bone where there is no oxygen and your T cells can’t get to her to kill her off.

                           

                          So for me, Yes the TKI are the best we have.  But I don’t agree that CML is a simple cancer I think it is much more complicated then just killing leukemia cells at the lower level.  I mean that stem cell is close to the top of the change before it even makes the Red Cells, White cells, Platelets.  It’s just the White cells are nucleus with with 23 pair of chromosome, while the red cells and platelets are not nucleus.  So it is the white cells with the chromosome that are turning on and making copies, I think that is right.  If wrong Trey will get after me to just paste a link. 

                           

                          I am still patiently waiting on the promise cure, which at this time is only a Transplant.

                           

                          PamSouth

                          • Re: Swiching Meds
                            billronm@roadrunner.com Registered Users
                            Currently Being Moderated

                            Hi Pam,

                              I felt yuckky yesterday,but I'm going to hit the Post Office on Monday.  Lot's of love Billie

                             

                            Maybe Tuesday I'll hit the bank,us old broads can still go crusing!

                            • Re: Swiching Meds
                              pamsouth Registered Users
                              Currently Being Moderated

                              Got Cha Billie, 

                               

                              I have a pot roast in the crock pot for  tomorrow.  I wish you could come an join me. Oh heck the whole lot of you, Judy2, Pam M, Oh just bring the gang and, a side dish.  Maybe a little whine and cheese.  Ya Cheese Cake with some Strawberries.

                               

                              PamSouth

                              • Re: Swiching Meds
                                pammartin Registered Users
                                Currently Being Moderated

                                Hey, I was invited to a party and didn't know it!  Heading out for choc covered strawberries and sangria, summer food and beverages!

                    • Re: Swiching Meds
                      hannibellemo Registered Users
                      Currently Being Moderated

                      Hi, Judy!

                       

                      Yesterday I could not get my head around my job so I spent the afternoon reviewing the NCCN CML Guidelines.   I don't know how pertinent the CML specialists find them because they all seem comfortable doing what ever they think might work for their patients. However, for those of us who don't see specialists, they are helpful for us and our docs.

                       

                      What I found interesting is that while MMR and PCRU (CMR) are listed in the definitions of the guidelines they are not listed as the "goal" of treatment. The highest goal is CCyR to be reached within 18 months. Now common sense dictates that if we reach MMR or CMR within that timeline or, ever, for that matter, and maintain it we are ahead of the game.

                       

                      These guidelines lead me to believe that those of us who have a stable CCyR for years are doing fine! It also leads me to believe I would shy away from any doc who has "PCRU or bust" as his/her goal for their patients regardless of how the patients are doing on their current drug.

                       

                      Just my two cents worth.

                       

                      Have a great weekend!

                       

                      Pat

                      • Re: Swiching Meds
                        Judy2 Registered Users
                        Currently Being Moderated

                        Hi Pat and Pam S.,

                         

                        Pat, thanks for your 2¢, I  think I am well into brain fog and therefore need all the extra brain power I can get. I'm wondering when the guidlines were written or updated. If it was before Tasigna and Sprycel maybe the oncs could only anticipate a fair response where the prognosis wasn't as good. Now with T. and S. perhaps we are able to have a better long term outcome so if people are not doing as well on Gleevec they can be switched with the hopes of a better prognosis. Just a thought.

                         

                        Pam S., I have to say I got a laugh when you posted that if you are wrong Trey will get after you to post a  link.

                         

                        Judy

                      • Re: Swiching Meds
                        pamsouth Registered Users
                        Currently Being Moderated

                        Hanni,  I am with you.

                             “"These guidelines lead me to believe that those of us who have a stable CCyR for years are doing fine! It also leads me to believe I would shy away from any doc who has "PCRU or bust" as his/her goal for their patients regardless of how the patients are doing on their current drug.”"

                         

                        Hanni, I think that is worth a lot more then 2c.  That is exactly where my thinking.  I mean if you look at all the documentation from the leading CML Experts, I think that is about the most general truest statement you can make, without making it more complicated.

                         

                        PamSouth

                    • Re: Swiching Meds
                      Trey Registered Users
                      Currently Being Moderated

                      The most important thing in CML treatment is a stable and durable drug response.  Deeper responses are statistically more likely to be both stable and durable.  But many can meet these two criteria in CCyR or better; and Dr Druker has suggested that he believes CCyR is the most important of the treatment milestones.  It would be unusual to meet these two criteria with less than CCyR, but it can happen. 

                      • Re: Swiching Meds
                        Judy2 Registered Users
                        Currently Being Moderated

                        Hi Trey,

                         

                        Thanks. I know this is going to sound like a stupid question but I am very "fogged out" right now. When I was dx my BMB showed 20 out of 20 cells positive for the Philadelphia Chromosome. Would I be able to tell how many were positive from the level of my PCR , say if I was down to 1% PCR then could I assume I was in CCyR, or would I have to have another BMB? Thanks.

                         

                        Judy

                        • Re: Swiching Meds
                          Trey Registered Users
                          Currently Being Moderated

                          A single PCR number by itself does not mean anything since lab numbers vary widely.  Ask your Onc if your PCR shows a 2 log reduction, which is roughly equivalent to CCyR.  After CCyR BMBs are no longer necessary unless the patient has other high risk factors.

                          • Re: Swiching Meds
                            Judy2 Registered Users
                            Currently Being Moderated

                            Hi Trey,

                             

                            Thanks, now I know when I hit a 2 log reduction I will be CCyR, not there yet.

                             

                            Judy

                            • Re: Swiching Meds
                              pammartin Registered Users
                              Currently Being Moderated

                              Judy,

                              Hang in there, it will happen!

                              Pam

                              • Re: Swiching Meds
                                Judy2 Registered Users
                                Currently Being Moderated

                                Hi Pam M.,

                                 

                                Thanks for your support, I know it will. My night sweats have improved so I think my next PCR test will be much lower, fingers crossed.

                                 

                                Judy

                                • Re: Swiching Meds
                                  pammartin Registered Users
                                  Currently Being Moderated

                                  Hi Judy, awesome!  It is funny, my night sweats are at an all time high, but the labs say things are good.  Perhaps it is menopause.    Nice to see you, I have been worried.

                                  • Re: Swiching Meds
                                    billronm@roadrunner.com Registered Users
                                    Currently Being Moderated

                                    Hey You guys, Where have you been?

                                       Strawberries and chocolate, and A cookout. Now I am really depressed, Not only did I have another birthday Sunday,but Ron took me out to dinner and I had liver&onions!  I wanted an ice cream cake from Dairy Queen!       It's hell getting old.                            Sad Billie

                                    • Re: Swiching Meds
                                      pammartin Registered Users
                                      Currently Being Moderated

                                      BIllie!

                                      Happy belated birthday.  I hope the liver and onions were your idea, that is an aquired taste!  You are only two hours away, as soon as I know the weather is good I am coming up there and taking you to Dairy Queen.  I will get you your cake, you just bring the spoons. 

                                      • Re: Swiching Meds
                                        billronm@roadrunner.com Registered Users
                                        Currently Being Moderated

                                        Pammie,

                                           That's the problem, I wanted liver and onions.  Only old people like Liver. There's a Dairy Queen about 4 miles from my house. I think we should set the whole cake on the table, I'll get out 2 of my biiiggg spoons and we;ll eat the whole thing. And we'll make it an open invitation to everyone on the board. Could you see all of us asassinating a huge DQ cake?  That would be a hoot! And we won't even have to clean up the mess, Annie just loves to clean the floor and do the dishes. Hell I haven't washed dishes for 11 years. Now if I could only teach her to vacuum.      luv Billie

                                        • Re: Swiching Meds
                                          pammartin Registered Users
                                          Currently Being Moderated

                                          Billie,

                                          Are you sure you want to share.  I mean, uh, those cakes aren't all that big, enough for just a few er uh, me, oh I mean you too.  Perhaps we should have two tables and bring Annie to clean up the mess, we will get them completely without chocolate.    (I am old and I don't like liver and onions, oh, well I do like onions, but not the liver.)  Give me an extra rare steak of any form and I am happier than a pig in poo.

    • Re: Swiching Meds
      pamsouth Registered Users
      Currently Being Moderated

      Headi wrote:

       

      My onc has suggeted that I will also be going to Tasigna from Sprycel at the end of March.  I paid attention to advise from folks on this blog and took a weeks vacation before going to Sprcel.  The transition was very easy. I tolerated it much better than Glevec. I am a bit worried about going to Tasigna as i'm tolerating Sprycel very well. Would be very interested in how you end up handling it, Badger. I would also love to hear from some who have already gone through the transition to Tasigna and some information on what to expect. I don't know f this is any help to you, but I'm leaning towards a week of no meds unless someone can advise if & why this would be a mistake. Thanks to all

      If you are tolerating Sprycel well, why would you switching to Tasigna. How long were on Sprycel? When were you diagnosed?  I am assuming you started with Gleevec?

       

      PamSouth

  • Re: Swiching Meds
    CathyS Registered Users
    Currently Being Moderated

    I would like to know what it is like to change meds also.

    I am on Sprycel and may need to change to Tasigna

    Background Info;

    I was diagnosed in August 2011 started Sprycel. I went through not feeling well for a few weeks then it tapered off I still experiencing a few side effects that I am dealing with, then I started having trouble breathing and it started getting worse since the beginning of January the last two weeks I can hardly walk down a hall way with out gasping for a breath. I did have a bunch of other test to rule out any other things that could cause how I am breathing they were all good. So they decided to stop the Spycel for a week I go back next Tuesday and then we need to make a decision about changing to Tasigna. I asked my onc if we could just reduce the dose of Srpycel currently 100mg  my suggestion is to drop it to 20mg and take curcumin along with it because I have read so much about curcumin on this site..

    She said I can take the curcumin but she feels strongly that no matter what the dose of Srpycel is it could still cause the breathing.

    Question how did some feel when you started taking Tasigna?

    • Re: Swiching Meds
      hannibellemo Registered Users
      Currently Being Moderated

      Cathy,

       

      There is some anecdotal evidence that Sprycel can cause issues like this. If you go to http://www.newcmldrug.com and search for Leah's most recent thread. She talks about experiencing this and says that Dr. Druker has had other patients that go through this with Sprycel.

       

      I also had a very tough 2-3 months shortly after I started Sprycel 21/2 years ago with shortness of breath, increased heart rate with little exertion, general malaise, etc. It disappeared and I have had no return until 2 weeks ago when I developed a sharp pain in my right side when taking a deep breath and some shortness of breath when climbing stairs, etc. X-ray showed a very small PE in my right lobe. My local onc and a good friend who is a liver specialist both expressed surprise that I am experiencing any symptoms from such a small PE so we're looking further. I  will have an echo cardiogram on Friday to look for any cardio involvement; they don't really expect to find anything but it will make me feel better - maybe, depending on the findings!

       

      I am hoping we can manage this somehow, dose reductions, diuretics, etc. but I may also being switching in the future. As Gilda Radner said, "It's always something!"

       

      Good luck, Cathy!

       

      Pat

    • Re: Swiching Meds
      chriskuo Registered Users
      Currently Being Moderated

      Did they take x-rays both standing up and lying down to rule out pleural effusion?

       

      Do you show any signs of water retention in your legs and ankles?

      • Re: Swiching Meds
        CathyS Registered Users
        Currently Being Moderated

        chriskuo

        No they only took them standing. But I did have a CT of my lungs.

        I do not have any fluid retention.

        CathyS

         

        Message was edited by: cathyS

  • Re: Swiching Meds
    pamsouth Registered Users
    Currently Being Moderated

    I also hear that Tasigna is cheaper then Sprycel which became a patent in 2009.  I think Tasigna became a patent in 2007, not sure.  Does insurance have a say on which TKI they will pay for?

     

    Just wondering, PamSouth

    • Re: Swiching Meds
      chriskuo Registered Users
      Currently Being Moderated

      Neither one is going off patent soon, unlike Gleevec, which only has a few years to run.

       

      The cost of Tasigna and Sprycel are pretty comparable and substantially more than Gleevec.

       

      One difference between Tasigna and Sprycel is that Tasigna is supplied in weekly blister-pack boxes, so you get

      4 boxes for your monthly supply.  Sprycel is usually dispensed 30 pills at a time.

      So, over the course of the year, you are likely to have 13 co-pays for Tasigna and 12 co-pays for Sprycel.

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