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Is it a good idea to change bosutinib to asciminib?

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Hello everybody,

                         I have had CML since 2004. I took Imatinib 400 but mutated in 2011. I switched to dasatinib 50 but had a pleural effusion in 2019. I switched to bosutinib 300 but my creatitine level has gone up a lot. I now have diabetes 2 in addition to kidney failure. I am now having pleural effusion and high blood pressure. Is there a patient in this group who has the same profile as me? My hematologist thinks it would be a good idea to switch to asciminib. What do you think?

Thank you very much in advance for your reply.

What have your test results shown over the last nineteen years and what dosage of each TKI were you on at that time?

My results were very good with all the TKIs - I became PCRU with all of them. I lost PCRU with imatinib due to the mutation. On the strength of this good performance, I am trying to stop bosutinib in 2019. I failed the tfr (treament_free remission) six months later.

My CMLer ID ==> CA5311040814490    
My CML Medication Status (history)
0-1000000000-400-20050620 ==>  400 mg of imatinib
0-1200000000-050-20110112 ==>  50 mg of dasatinib
0-1250000000-300-20160117 ==>  300 mg of bosutinib
1-1250000000-000-20190610 ==>  in TFR
0-1250000000-300-20190914 ==>  300 mg of bosutinib

 

I have somewhat the same profile as you, and yes, I would jump at the chance to switch to asciminib.  I maintain MR4 to MR4.5 on just 20 mg dasatinib, but have minimal residual pleural fluid that ain't going anywhere.  After 14 years and at age 71 I am restless and ticked off a little.  If I could try asciminib, I would, to see if I could have some years left where I don't have drinker's eyes, saggy pale skin, no hair, and low energy.  

Thank you for your information. A patient told me that the pleural effusion decreased with asciminib without completely disappearing.