You are here

Imatinib (Gleevec) VS Dasatinib (Sprycel)

So I have been recently diagnosed with CML. I am a healthy 33 year old male.

I am a Canadian, but I have been living in the USA for the last 6 months. During a trip to Canada, I was diagnosed.

My Canadian doctor's preference is to start on Imatinib and my USA doctor's preference is to start on Dasatinib.

I know Imatinib has been around longer, therefore they have more data on it, and my impression of Dadatinib is that it can help you reach the milestones quicker and has less side effects.

Does anyone have any thoughts on which drug I should start on? Any insight would be appreciated.

Thanks,

Hi

Ultimately you should decide in consultation with your doctor, however I was very keen to use Dasatinib over Imatinib doe to the statistically demonstrated faster and deeper responses it brings, and its ability to manage more of the potential mutations.

It is also relatively well tolerated compared to Imatinib. However there are additional risks with Dasatinib, most notably pleural effusion, and Pulmonary Arterial Hypertension.

Either drug is likely to work well, in the end.

If you're paying for it, Imatinib is likely to be cheaper.

Rod

Hi,
I think Rods advice is good. It depends on your insurance and the cost between the two you mention. Also it depends on whether you have any co-morbidities/other health issues that may affect your choice of 2g TKIs (nilotinib, dasatinib, bosutinib). Personally, I would talk to the US clinician about the option. 2nd generation TKIs have been around for quite a while and so the data is there- certainly for dasatinib and nilotinib and increasingly for bosutinib which from what I can gather is proving to be a very good option.

The issue is that it is increasingly obvious to get you PH+ cells down to the lowest you can in the fastest time possible. 2nd gen TKIs have proven to be better at doing this in the majority of newly diagnosed in chronic phase.....although imatinib is as effective in a smaller percentage of cases.

Hope this is helpful,
Sandy