“The patients were started on dasatinib 50 mg daily and were monitored every 3 months the first year and every 6 months thereafter," she explained. “However, patients that had suboptimal response by the ELN 2013 criteria had the option to increase the dose to 100 mg daily, as well as those patients that had significant or unacceptable adverse effects, could decrease the dose to 20 mg daily."
At 5 years, the cumulative incidence rates of CCyR, MMR, MR4, and MR4.5 are 98 percent, 95 percent, and 82 percent, respectively, Gener-Ricós told Oncology Times. “We compared these results with the historical data in the DASISION trial and we showed that the cumulative incidence rates of response were higher with dasatinib 50 mg daily at any time point, compared to dasatinib 100 mg daily or imatinib 400 mg daily."
I have written many times before that 100 mg dasatinib is too high a starting dose for many CML patients - and can actually lead to a lower response to treatment than a lower dose. This study was completed at M.D. Anderson, the same institution which put me on low dose dasatinib as a way to deal with my myelosuppression (20 mg) and I achieved a much higher response than my initial dosing protocol.
This is why it is important for patients who take dasatinib (and the value of this forum) discuss with their doctors these results. No one should be prescribed 100 mg starting dose of dasatinib. The starting dose should be 50 mg. and then adjusted up OR down as response is indicated.
For those already on 100 mg dasatinib with no obvious adverse events - perhaps suggest to your doctor your dasatinib dose be reduced and response closely tracked. Chances are your response will go up.
Keep in mind - this is a hard concept for many - MORE drug does not mean MORE response in all cases.