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Starting Bosulif - input please

Hi, After 18 months in TFR my husband's PCR is up to .32 and is starting Bosulif.  The drug he was on immediately before TFR was Sprycel 50 mg that caused severe shortness of breath (but not a pleural effusion).  He is not returning to Sprycel because of the pulmonary problems.  He was a very fast and deep responder after diagnosis in 2012 and again after a short TFR attempt in 2016 so we have every reason to hope and believe he will return to MMR quickly.  

He will start on 100 mg and increase slowly to 200 mg and hope that does the trick.  If not, he will go up to 300 mg.  We are aware that there could be diarrhea and that the bloodwork could show liver problems.  

I would appreciate hearing from anyone who is on Bosulif with any feedback.  Thank you very much.

Alison

 

Hi and good luck to your husband on Bosulif - will be interested to hear if 100 mg does the trick to get him back to MMR and below.  Please read my post "Should I try TFR." I am similar to your husband in that I was a very fast responder to Tasigna but even on 25% of starting dose still experiencing heart palpitations that could be caused or exacerbated by Tasigna.  I want to either stop Tasigna (TFR attempt) or switch to Sprycell or Bosulif low dose, but my onc will not permit me to switch to anything but full dose of another TKI (100 mg Spycell or 400 mg of Bosulif).  Apparently your husband's onc is willing to let him start low on Bosulif and go up only if needed.  How did you convince him/her to do that?  Any arguments that I could use with my onc would help.

Also, would you be willing to share your husband's onc's name and contact info to me?

Thanks very much

@cmljax Any CML specialist (as opposed to a community oncologist) will know all the latest dosing recommendations.  My husband's specialist expects he may need 200 or 300 mg Bosulif but is willing to start at 100 mg and titrate up depending on side effects.  I have seen others describe going up slowly to minimize side effects.

When my husband first went on Sprycel he started at 70mg.  

Here's an article about 50mg being the possible new starting dose for Sprycel:  https://www.ncbi.nlm.nih.gov/pubmed/29723397

Thank you so much Alison for this response and for your other response to my post.  If you guys are in the US, would you mind sharing the name and contact info for your husband's specialist?

@cmljax His specialist is not as involved in CML as he used to be and you would be way better off consulting with someone who is totally immersed in CML.  There are plenty around.