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Nilotinib to Imatinib


Hi. Anyone have any experience of changing from Nilotinib to Imatinib? I have a new care provider and this is my option. I have successfully been taking Nilotinib for the last 5 years. I have experienced very few side effects apart from raised cholesterol. The change is purely down to the policy of the new provider (presumably due to cost?)
There is an option to return to Nilotinib or Desatanib should Imatinib prove unsuccessful due to side effects or a rise in BCR-ABL % (reduction in MMR response).
Any personal experience or reference to any studies or papers would be much appreciated.

WillO I deleted my initial response but I did want to convey this thought. If you’ve been on Nilotinib for 5 years then that probably means you haven’t reached MMR4.5. I hope I am wrong but if that is the case switching to imatinib may actually work out better for you. It is the opposite for me. After 10 years on imatinib I never reached CMR but on Nilotinib I achieved that in less than a year. I was told by an oncologist that how the proteins bond to these drugs determines their effectiveness. For me imatinib was like a square peg fitting into a round hole. The bond was made it just wasn’t a tight fit. At least on Imatinib you could probably stop taking the statin as hyperlipidemia is not a side effect. And I agree they want you off nilotinib because of cost. Good luck on this.

Hi, sorry for the late reply to this but I somehow missed it in November.

I went "backwards" from dasatinib to imatinib, so it is definitely possible to go from a 2nd generation drug to imatinib. In my case it was associated with increased side effects but an improved response. So there's no reason not to try and see what happens!

The one thing to bear in mind is that imatinib and nilotinib work in the same way as they bind to the same site when inhibiting the tyrosine kinase protein. Dasatinib works in a completely different way. That's why it might be better to change to dasatinib instead given that it has a different mechanism of action.

Let us know what happens!

Best wishes


Hi Martin. Thanks for the reply, it’s good to know it worked out for you. I seem to be ok so far. Some minor differences but nothing significant.