Has started Ponatinib 15 mg from 22nd December 25. Initially no side affects. Only elevated pancreatic enzymes. But now when almost 1.5 months the blood sugar and blood pressure is alarmingly high. Telmisartan dose has been increased from 20 to 40mg. For glucose control I am taking METFORMIN 1000+LINAGLIPTIN 2.5 mg daily. Even after taking those for almost 20 days the glucose levels and blood pressure is not totally under control. Don’t know what next.
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Ponatinib side effects
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Depending on where you are with blood counts and BCR-ABL %, you may consider going back to Imatinib and adding 200mg Mebendazole, which seems to be very effective against all CML mutations, including T315I, at least in the lab tests.
It's an FDA approved dewormer (anti-parasitic), which has not been approved as anti-cancer therapy, but lots of papers discussing lab test findings show that it's very effective against cancers in general through activation of P53 and disruption of microtubules and glucose uptake used for feeding during cell division.
It's shown to downregulate most of CML LSCs signalling pathways including Hedgehog, Notch1, NFKB, MDM2 etc. These are key survival mechanisms in CML LSCs, so it seems it uses multiple attack vectors and not only inhibition of ABL1.
It's considered a non-toxic medication, but may cause elevated liver enzymes, which reportedly rapidly normalise upon discontinuation. Larger doses may cause stomach issues.
It's embryotoxic, so not to be taken during pregnancy.
It inhibits the enzyme CPY3A4 which is used for metabolising TKIs, so it may lead to accumulation of TKIs in the system, however, it's removed from the blood withing 2-4 hours so it should not cause significant issues.
You would need to test weekly while on it in order to monitor for any changes in blood counts such as liver enzymes, at least for the first month or so.
I have started taking it 2 weeks ago in order to see if it can eradicate CML, but will not know if it has any effect until mid of April. So far I have no issues. I take my TKIs in the morning (Asciminib and Dasatinib) and then Mebendazole afternoon after a meal for better absorption.
Discuss it with you doctors and see what they think.
Btw, it's very cheap.
https://grokipedia.com/page/Fenbendazole_and_mebendazole_in_cancer_treat...
https://cancerchoices.org/therapy/mebendazole-or-fenbendazole/for-health...
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https://www.mdpi.com/1420-3049/24/11/2152