Re: More from ASH -easier to read response

[Guest guest]

That last post of mine looked so jumbled that I'm sure few were able

to follow it Unfortunately, it didn't come out as clean as I had

written it on my computer (where I used different colours to

differenciate between 's words and my own, so here goes a

better, easier to read post.

Once again, thank you so much for taking the time to share

all of this with us. I have a few comments on this latest report:

What an exciting thought! I hope it pans out to be that we can

actually halt the progression of CML. Wow, the thought of it just

makes me want to jump

Measuring phosphorylation of CRKL sounds like it could be of such

important clinical value (if they actually measured it in patients).

Any idea why they aren't doing it?

Was there any news on the new drug that was rumoured to be in trials

(or soon to be in trials) that specifically targets the T315I

mutation?

When you talk about the 30% of medication that isn't taken, do you

mean that people aren't consistant with taking their Gleevec (some

days they take it, others they don't) or that they'll take half as

much as they're supposed to? Or perhaps both? We can't always blame

the patients either (unfortunately), it seems that there are still

some doctors out there who aren't familliar enough with Gleevec and

are still playing around with sub theraputic doses or playing the

intermittent game (take it when you feel like it or don't take it if

you don't feel like it etc).

Also, how did they come to this conclusion? Is it from interviewing

patients or by comparing written prescriptions with orders put in by

the pharmacies? Sounds kinda high to me, so I wonder what criteria

they used to form this conclusion. Is someone who missed one dose in

6 months considered to be non-complient or does it take a couple of

doses? I just wonder how they define " poor adherence " .

With much appreciation for your time and insight,

Tracey

[Guest guest]

Hi Tracey - Just quickly because I'm on the road.

>

>

> Measuring phosphorylation of CRKL sounds like it could be of such

> important clinical value (if they actually measured it in

patients).

> Any idea why they aren't doing it?

I don't know why not - except that for most of us, measuring BCR/ABL

by PCR is adequate for following our progress. One piece of good

news I didn't get from ASH is that more sensitive and reliable PCR's

are on their way. I'll write about that at another time.

>

> Was there any news on the new drug that was rumoured to be in

trials

> (or soon to be in trials) that specifically targets the T315I

> mutation?

A number of labs are working on this. I heard a talk just before I

left by a drug company researcher(I don't have the name of the

company in my head)who's working on this and seems to have a

compound showing great promise: it targets BCR/ABL (which from now

on I'm going to call BA, so save typing - lots of folks do this

nowadays) in the active conformation, as opposed to the inactive,

which IM targets (dasatinib, which I'll call DS from now on) targets

both comformations); has the same activity against " wild type "

(unmutated, that is) BA as do IM, DS and the BMS drug; but which

specifically inhibits T315I mutated cells. They've only studied it

in vitro so far, but in testing it against the human kinome (all

known human kinases - a great new word, or new to me, anyway), it

shows lower toxicity than these other drugs. They hometo bring it

to phase I trial less than 2 years.

One of the amazing things I'm learning here is how incredibly

powerful and fast drug discovery technology has become. If only the

machinery for bringing good new drugs to market were a bit faster!

>

> When you talk about the 30% of medication that isn't taken, do you

> mean that people aren't consistant with taking their Gleevec (some

> days they take it, others they don't) or that they'll take half as

> much as they're supposed to? Or perhaps both?

Both, I think. Of course, I am one of these patients, but I do my

pulse regimen in a much more rigorous (and, I hope, safe) way than

arbitrarily skipping doses when I feel like it. Btw, there was a

lot of interest by researchers here in what I'm doing.

>

> Also, how did they come to this conclusion? Is it from

interviewing

> patients or by comparing written prescriptions with orders put in

by

> the pharmacies?

The latter - scripts filled less frequently than expected.

See ya later,

R