Susan:
So terrific that you are doing and feeling so well. You look great in all of
your FB pictures and I'm so happy to see that!
Marcie
-----Original Message-----
From: Myvety2k via CMLHope <cmlhope@googlegroups.com>
To: cmlhope <cmlhope@googlegroups.com>
Sent: Tue, Nov 18, 2014 10:59 am
Subject: Re: [CMLHope] Digest for cmlhope@googlegroups.com - 2 updates in 2
topics
Well thank you Susan.
greenie
In a message dated 11/18/2014 9:25:11 A.M. Eastern Standard Time,
cmlhope@googlegroups.com writes:
So glad you are negative, too, Greenie!!! Let's do the happy dance
together....wish I knew how to put footprints on here!
18's,
Susan
-----Original Message-----
From: Myvety2k via CMLHope <cmlhope@googlegroups.com>
To: cmlhope <cmlhope@googlegroups.com>
Sent: Tue, Nov 11, 2014 4:05 pm
Subject: Re: [CMLHope] Digest for cmlhope@googlegroups.com - 2 updates in 2
topics
I received my results back from my 6 month blood work today and I'm Negative
on BCR-ABL.
greenie
In a message dated 11/11/2014 2:14:49 P.M. Eastern Standard Time,
cmlhope@googlegroups.com writes:
Happy Veterans Day to all
Jeanie
Sent from my iPhone
On Nov 11, 2014, at 1:56 PM, Myvety2k via CMLHope <cmlhope@googlegroups.com>
wrote:
Thank you Elizabeth, I served 6 years in the Navy.
greenie
In a message dated 11/11/2014 1:43:34 P.M. Eastern Standard Time,
ksnwo...@prodigy.net writes:
Thinking of you all. Nick is critically anemic due to Gleevec. Hope
Richard H., Shannon, Bobbie Doyle, and all keep up your sharing of
info. thanks so much Marty for the reports from the clinical trials to
reduce or stop Gleevec.
Thank you to all Veterans on this day. Elizabeth Woods
On Tuesday, November 11, 2014 4:32 AM, "cmlhope@googlegroups.com"
<cmlhope@googlegroups.com> wrote:
cmlhope@googlegroups.com
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Glivec and studies of stopping the drug - 1 Update
Digest for cmlhope@googlegroups.com - 6 updates in 2 topics - 1
Update
Glivec and studies of stopping the drug
Richard H <rbhuffm...@gmail.com>: Nov 10 09:05PM -0800
Yes. This was the reason I stopped Gleevec. I was also had Iron
Deficient
Anemia. I had to infuse the iron to help try to recover my RBC
count
because was below 9. I was also still taking Gleevec while doing
this.
On Monday, November 10, 2014 12:56:18 AM UTC-6, Shannon L wrote:
Back to top
Digest for cmlhope@googlegroups.com - 6 updates in 2 topics
"Sue" <hol...@iinet.net.au>: Nov 10 07:13PM +0800
Hi Shannon
There is also the Destiny Trial in the UK which is reduction down
to 200mg for 12 months and then stop (there has been no report
until after Dec 2014)
The next Trial is named Spirit3 to see if people are being over
medicated
The Australian Survey will have 600 participants
Sue Hurt
(Australian)
From: cmlhope@googlegroups.com [mailto:cmlhope@googlegroups.com]
Sent: Monday, 10 November 2014 6:22 PM
To: Digest recipients
Subject: [CMLHope] Digest for cmlhope@googlegroups.com - 6
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* Glivec and studies of stopping the drug - 5 Updates
* Glivec and studies of stopping the drug - 1 Update
<http://groups.google.com/group/cmlhope/t/839da881a2e6e455?utm_source=digest&utm_medium=email>
Glivec and studies of stopping the drug
Shannon L <shannonl.cam...@gmail.com
<mailto:shannonl.cam...@gmail.com> >: Nov 09 03:58AM -0800
Hi All My name is Shannon I live in Sydney Australia
Its been awhile since I have posted.
I was diagnosed 1998 and after a few years went onto sti571
(glivec) and
achieved remission within 2 months and I have been it ever since
about 14
yrs.
They are inviting participants (in Australia) to take a survey of
stopping
glivec I image they will do a study of stopping the drug.
My question is does everyone know of the study done in USA of the
stats of
stopping they have indicated in this survey info that the
percentage of
success is 30-40% to me that SEEMS LOW what do you think.
I do have some problems but I am stable on glivec.
I hope this emil finds everyone well
Shannon
Marty Gartenberg <wa2...@gmail.com <mailto:wa2...@gmail.com> >:
Nov 09 07:46AM -0500
Hi Shannon, there is a study called the STIM that is going on in
the UK and
it talks about Imatinib being stopped. It is kind of lengthily
however it
does go into detail.
Good luck to you, and I have always said there will be a cure for
CML in
our lifetimes.
If you follow any of my posts I always end them with two numbers.
They are
18 which is the symbol for life.
18's to you Shannon
Marty
PS Shannon I encourage you to post any time that you like. There
will
usually be someone that may be able to answer your questions.
Besides that
we are all here to learn from and help each other
Can Imatinib Be Stopped?
Goodwin, Peter
Article Outline
[image: Collapse Box]Author Information
ASH Abstracts 186 and 187
SAN FRANCISCO—The early promise of the tyrosine kinase inhibitor
(TKI)
imatinib for treating chronic myeloid leukemia (CML) has
continued to be
fulfilled following the release of seven-year follow-up data at
the ASH
Annual Meeting here from the International Randomized Study of
Interferon
versus STI 571 (imatinib) (IRIS) with 553 patients.
With diminishing rates of progression each year beyond year
three, the case
for stopping imatinib altogether was also discussed at the
meeting
following release of results from two studies in which the drug
was
discontinued among patients who had achieved enduring complete
molecular
responses to it for more than two years.
IRIS investigator Stephen G. O'Brien MD, PhD, Senior Lecturer in
Experimental Hematology at Northern Institute for Cancer Research
of
University of Newcastle upon Tyne, UK, gave the latest IRIS
results to a
packed audience at the meeting, showing an event-free survival
rate of 81%,
freedom from progression to accelerated phase/blast crisis of
93%, and an
estimated overall survival rate of 86%, from the standard dose of
400 mg
imatinib daily.
And in the presentation that followed, François-Xavier Mahon, MD,
Professor
at Victor Ségalen University in Bordeaux, France, released early
data from
the Stop Imatinib (STIM) study, noting that remissions continued
in about
half of the patients after investigational discontinuation of
imatinib
therapy—with a non-significant trend showing that patients
previously
treated with interferon were more likely to be among those whose
remissions
persisted without drugs.
Dr. O'Brien said that in IRIS the projected cytogenetic response
rate to
imatinib (by Kaplan Meyer analysis) was 82%, and that after seven
years of
follow-up 60% of patients were still on imatinib, with 57% of all
patients
still in complete cytogenetic response (CCR).
The impression that CCR holds the key to a “cure” of CML was
strengthened
by comments he made after his talk:
“It seems that if you maintain your CCR for, say, three years,
the chance
of regressing at that point is essentially zero. So, achieving a
CCR is, I
guess, what we call a ‘safe haven’ for the majority of patients:
If you've
achieved that and sustained it for, say, three years, you're in
pretty good
shape and the chance of progressing is virtually nil,” he said.
Back to Top
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_Stopped_.1.aspx#
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_Stopped_.1.aspx>
>
| Article Outline
Diminishing Rates of Relapse
These words reflect the diminishing rates of relapse observed in
the IRIS
study in successive years. Rates of progression to accelerate
phase or
blast crisis each year were low at all times—with rates rising in
the first
two years (1.5% in the first year; 2.8% in the second year) and
then
diminishing after that (1.6%, 0.9%, 0.5%, 0%, 0.4% in years 3, 4,
5, 6, and
7, respectively)—with only a single patient having disease
progression to
accelerate phase or blast crisis between years six and seven.
[image: Figure. FRANOIS-XAVI...]
Figure. FRANOIS-XAVI...
Image Tools
The total annual event rates, including loss of molecular complete
remission and death, were similarly low (3.3% and 7.5%) in years
one and
two, and diminished thereafter (4.8%, 1.7%, 0.8%, 0.3%, and 2.0%
in years
three through seven).
These data only apply, of course, to the majority of patients who
prove
sensitive to imatinib, and Dr. O'Brien noted that many patients
who are
resistant or refractory to the TKI are now candidates for other
drugs and
in some cases, allogeneic transplantation.
Dr. O'Brien summed up his feelings about the current state of the
art
concerning imatinib therapy for CML: “I think it's encouraging on
two
fronts. One is that there's nothing new in years six and seven to
cause
alarm in terms of safety events. And the second is—particularly
in patients
who achieved a complete cytogenetic response—I think we can be
very
reassured that the vast majority—especially if you have that CCR
for three
years—are doing extremely well, with very few of those
progressing.”
Back to Top
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_Stopped_.1.aspx#
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_Stopped_.1.aspx>
>
| Article Outline
STIM Study
Encouraging data on long-term remission of CML among patients
treated with
imatinib gave rise to the French initiative to conduct a pilot
study with
15 patients looking at stopping imatinib, and following this the
multicenter STIM study with 50 patients, which began in July 2007
but which
has already yielded early—but provocative—evidence that remission
from CML
can continue even after imatinib is stopped.
Dr. Mahon said that patients were recruited into these studies
only if they
had received imatinib for at least three years and achieved
sustained
complete molecular remission (CMR) for two years before
experimentally
stopping the drug.
The definition of sustained CMR was strict: BCR-ABL/ABL had to be
below a
detection threshold corresponding to a 5-log reduction
(undetectable signal
using RQ-PCR) for at least two years. Molecular relapse was
defined as
RQ-PCR positivity detected in two successive assays, and patients
who
relapsed were then retreated with imatinib (successfully) at a
dose of 400
mg daily.
In the latest follow-up of the pilot study, Dr. Mahon said that
seven out
of 15 patients had relapse within six months and all were
restored to CMR
by re-treatment with imatinib. The remaining eight patients were
still in
CMR a median of 37 months after stopping the drug.
All of the patients in the pilot study had been treated with
interferon
before receiving imatinib, most of them responding to it. This
raised the
suggestion—which Dr. Mahon discussed in his talk at the ASH
meeting—that
interferon may have conferred a benefit among patients who were
subsequently treated with imatinib.
Half of the patients in the STIM study had been pretreated with
interferon,
and some provocative—but as yet not statistically
significant—data have
emerged showing an advantage among those who had previously
received
interferon before going on to imatinib therapy.
By July 2008, 10 of the 15 patients who were still in CMR had
received
prior interferon. The latest assessment from a slide Dr. Mahon
presented
showed that 27 out of 49 patients followed for more than six
months had had
disease relapse; 14 of these had received only imatinib and the
remaining
13 had been previously treated with interferon, while only two of
the seven
patients in STIM who have so far continued in CMR for 14 months
had been
treated with imatinib alone.
Dr. Mahon summed up his interim conclusions by stating that they
have
confirmed that CMR can be sustained after stopping imatinib, and
that
although there seems to be an [as yet statistically unconfirmed]
advantage
among the patients who received interferon, it is possible to
stop the drug
in patients with sustained CMR even among those treated with
imatinib alone.
He reported that the probability of survival without molecular
relapse nine
months after discontinuing imatinib was 46%, with the curve
looking flat,
so far, out to 15 months. Importantly, the STIM study found that
all
patients were sensitive after imatinib re-challenge.
Back to Top
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_Stopped_.1.aspx#
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_Stopped_.1.aspx>
>
| Article Outline
‘Recurring Question’
When Dr. O'Brien was asked for a comment on Dr. Mahon's
conclusion from the
initial pilot study and the early results from the STIM study, he
said,
“I'm fascinated by it. There's probably a bit of a cultural
difference, I
think, because most of my patients in the UK—when I suggest
[stopping]—don't want to hand their pills back, and want to carry
on.
[image: Figure. STEPHEN G. O...]
Figure. STEPHEN G. O...
Image Tools
“I think that's driven by the fact that they are tolerating the
drug well.
There are no safety concerns emerging with the long-term
follow-up. And
it's obviously having good efficacy in them. But this is a
recurring
question that I think we'll see more and more of—and the French
study is
very important.”
Back to Top
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_Stopped_.1.aspx#
<http://journals.lww.com/oncology-times/Fulltext/2009/02101/Can_Imatinib_Be_Stopped_.1.aspx>
>
| Article Outline
Low Toxicities
In the UK, he noted, the preference for continuing imatinib could
be
explained by relatively low toxicities, which were not a
significant
barrier to its use, with neutropenia and thrombocytopenia being
minor
toxicities that are merely irritating over time.
“GI toxicity like diarrhea, for example, and a feeling of fatigue
and
malaise, sometimes, and muscle cramps can be troublesome in some
patients
over the years. But they're usually minor toxicities which, after
many
years, become rather wearing, rather than major toxicities,” he
said.
The bottom line for clinicians treating their patients with CML,
according
to Dr. O'Brien's interpretation of his IRIS results, is that
imatinib at
400 mg remains the current standard for first-line drug therapy,
even
though there are exciting data among patient cohorts treated with
nilotinib
and dasatinib first-line, with cytogenetic response rates in
excess of 95%.
“I think—for the future—where we're going is to do comparative
Phase III
studies with the tyrosine kinase inhibitors in newly diagnosed
patients to
see if we can improve on imatinib. Because although the imatinib
data is
reassuring, it's clear that at six or seven years, perhaps a
third of
patients are not continuing on imatinib,” he said.
*Supported by funding from Genentech BioOncology and Biogen Idec.*
© 2009 Lippincott Williams & Wilkins, Inc.
Shannon L <shannonl.cam...@gmail.com
<mailto:shannonl.cam...@gmail.com> >: Nov 09 03:52PM -0800
Hi Everyone
Thankyou Marty for the research information it was very
informative, so
they are combining stopping with interferon unfortunately I can't
tolerate
it I remember the first time before glivec.
I hope everyone is having a wonderful day.
On Sunday, November 9, 2014 10:58:55 PM UTC+11, Shannon L
wrote:
Richard H <rbhuffm...@gmail.com <mailto:rbhuffm...@gmail.com> >:
Nov 09 09:33PM -0800
What a great record. You didn't indicate how much Gleevec you are
taking.
I have read that several CMLers are taking reduced amounts and
reaming in
remission. I have seen a post by a lady that said see was very
petite and
she was only taking 100mg instead of 400mg.
I don't know the percentage or of a combined results From the
different
studies I read sometime ago I believe the range you have is
consistent with
what I have read. You can read my results below. My ONC told be I
needed
to end my almost 6 year vacation and I am trying to requalify for
a lower
copay for Bosutinib. I have tested and they found no mutation. I
have
studied the side effects and I will be meeting with a Nurse to go
over the
side effects. Due to my other problems I am concerned about all
the
interactions with those Meds.
I hope this has helped you.
Richard H.
Dxd 2/2003
400mg Gleevec 3/2003
Undetectable 11/03
RT-PCR negative 11/04
QT-PCR .003 11/05
RBC 8.
Gleevec Vacation 11/06-6/07
Iron infusion 11/06
Transfusions 12/06-5/07
QT-PCR .007
Gleevec 1/08 -5/08
Procrit 8/08-11/08
Gleevec Vacation 7/08-Present
QT-PCR .003 4/09
QT-PCR .0015 6/09
QT-PCR .0021 9/09
QT-PCR .0028 1/10
QT-PCR .001 4/10
QT-PCR .00468 10/10
QT-PCR 1.049% 2/11
QT-PCR .0612% 8/11
QT-PCR 2.616 % 2/12
QT-PCR 2.410% 8/12
RT-PCR 9.183% 4/13
RT-PCR 4.57% 6/13
RT-PCR 10.183% 10/13
RT-PCR 10.577% 2/14
RT-PCR 16.050% 5/14
On Sunday, November 9, 2014 5:58:55 AM UTC-6, Shannon L
wrote:
Shannon L <shannonl.cam...@gmail.com
<mailto:shannonl.cam...@gmail.com> >: Nov 09 10:56PM -0800
Hi Richard H
Yes Glivec 400 mg has been good to me I have been very stable on
the drug,
Wow 6 years off glivec thank you so much for sharing your results
just a
question in your first holiday off glivec you had an iron
injection is this
because of cml? I am contemplating a small break as my stomach
problems
seem to be increasing and are at times very debilitating. I know
I have
been on many meds prior to glivec (chemo twice, cytarabine,
hydroxia, and
interferon) and Im sure my body sometimes struggles with it all.
On Sunday, November 9, 2014 10:58:55 PM UTC+11, Shannon L wrote:
Back to top
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Glivec and studies of stopping the drug
myvet...@aol.com <mailto:myvet...@aol.com> : Nov 09 07:32AM -0500
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