Hi to the genius that is Scuba,about to start Dasatinib this week as Imatinib is slowing down , got down to 0.79% then 1.92% and 2.14% started it in December 2017.Doc wanted to start me on 100 mg but said I was scared of toxicity so has agreed on 70 mg.Have been told 70 mg tabs are not available anymore here so will get 50mg and 20 mg ,the burning question is should I take the 70 mg or just the 50 mg because I am so scared of changing because I had practically no issues with Imatinib.Thank you so much for all the advice and information you give to us all ,Keep well ,Denise.
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Scuba 50 or 70 Dasatinib
I would start at 50 mg initially to test response at the lower dose and potentially avoid many of the initial side effects. You should have your PCR tested at six weeks to verify your PCR is dropping. You can always increase dose and will have adapted. You might experience mild headache for a day or two, but it should fade away. I take my sprycel at night before sleep.
There is now a clinical trial for new patients at 50 mg. following up on early research suggesting 50mg should be the new standard of care: The trial doesn't apply to you as you are not a new patient, but research is showing that 50 mg is quite effective - and in some patients can be more effective (helps avoid immune suppression) than the higher dose. I assume your blood counts are near normal especially blast cells (ideally zero blasts). Show the papers below to your doctor so he is comfortable working with you at this dose.
In the work and reading I do I am surrounded by very smart people. I learn from them. Thanks.
I will tell you that if you can do 50mg then do it. I was on 100 for several years and some of the side effects were pretty bad. I feel like a new person after being on 70 now 50. Would love to go to 20 if I can talk my Dr. into it! My BCR remains stable at .0063.
No surprise to me. I am very pleased it is working for you. Once you fall below 0.01% consider lowering dose further. Dasatinib knocked your 'residual' down one log in a very short time. This is good news.
(reminds me that doctors should strongly consider rotating drugs for their patients - especially patients that plateau on one drug. And always with an eye to the lowest dose that works, dasatinib particularly)
Denise - I am another one who is staying stable at 0.006% IS on 20 mg Sprycel (for a year). No side effects except a small residual pleural effusion, also stable, symptom-free. You can do it! Let the 50 mg work for awhile - reduce to 20 mg in the future after you have strong continued success.
Show your doctor the literature and research articles you have seen posted here on the new findings regarding dose.
Remind her biology of cancer is not the same as biology of bacteria or virus'. Finding the correct TKI dose is about finding the least amount that works. We're all different, some need more drug to achieve a good trend downward, many of us actually need less drug. She should work with you to find the best dose which works. TKI's are toxic chemicals that can and will interfere with other vital body processes. That is a key reason to minimize rather than maximize dose. Unfortunately one size does not fit all.
If your doctor is not familiar, suggest she read up.