Re: Today's Teleconference

[Guest guest]

Hi Tracey!

Once again, you created excellent notes regarding the

teleconference. I am still amazed at how you can take such through

notes. ;-) I could hardly hear the teleconference on my phone; bad

connection or bad microphone volume.

I'm so glad Dr. Cortez brought up the serum level testing now being

made available to patients in the U.S.

I was the first patient in my Onc's office that has had this test

done.(I pushed and pushed and pushed, and knew about it before the

drug rep from Novartis even told the office that it was now

available.)

Although I have been PCRU, my side effects have been terrible, and

after my serum level tests came back, I can see why. I was sky high

on the test, and after my Dr. consulted with Dr. Druker, we are now

dropping my dose to 300 mgs Gleevec and retesting the serum level

soon, to see if I'm at a more appropriate serum level, along with

keeping the PCR test favorable. I must have the metabolism of a

snail!

I have not seen a change in side effects yet, but hopefully, with

time, the edema, swelling and fatigue will lessen. Keep your fingers

and toes crossed! This has been a huge struggle.

Lynn

Dx'd 12/03

300 mg's

PCRU

>

> Hi Everyone,

>

> In case any of you weren't able to listen to today's teleconference

> but were interested in what Dr. Cortes said, I've written a summary

> in two parts. This post will look at his initial " lecture " and my

> next post will have the question/answer period.

>

> He started with a brief history of CML saying that it was the first

> malignancy where a chromosomal change was found to cause a

disease.

> Past goals of CML therapy were simply to control blood counts but

> thanks to Gleevec and other targeted therapies, our goal now is to

> reach the source of the disease and allow patients to live long

term.

>

> Between the years of 1997-2007 there hasn't been much of a change

in

> the number of people being diagnosed with CML. Prior to 1997, 2400

> patients died a year from CML and now there are less than 500

> patients dying a year due to CML.

>

> Survival has gone from 3-4 years prior to Gleevec, to now 95% of

> patients are still alive after 5 years. The IRIS trial has shown

us

> that more than 80% of newly diagnosed patients have achieved a CCR

> which has been very durable over 5 years. The longer the patients

> are on Gleevec, the lower the rates of relapse are, which is very

> encouraging.

>

> He said that blood levels of Imatinib (Gleevec) can predict the

level

> of response a patient will have. Low concentrations of imatinib in

> the blood, don't give patients as good of a response as higher

> levels. He also said that serum testing of Gleevec is now widely

> available.

>

> The earlier the patient responds, the better the outcome. Patients

> who are in CCR at 1 year, have the best probability of a durable

> response. He mentioned that proper monitoring of disease is

> essential. FISH tests can have a false positive rate of up to 10%

so

> that should be taken into consideration when evaluating a patients

> results.

>

> A PCR test measures the patient's molecular response. A major

> molecular response (MMR) is a 3 log reduction. Each lab has a

> baseline value of what a newly diagnosed patient will have in terms

> of a PCR result. If for instance, the baseline is 50, then a one

log

> reduction would be 5, a two log reduction would be 0.5, and a three

> log reduction would be 0.05.

>

> Standard dose Imatinib has shown wonderful responses but higher

dose

> therapy can show faster and even deeper responses. He mentioned

> though that higher dose therapy (800mg) is still considered

> investigational, it's not by any means standard.

>

> Over the long term, side effects appear to ease up in most

patients.

> We used to be concerned about the long term effects of taking

Gleevec

> but after 5 years of use, we're not so worried anymore because

people

> seem to be doing better and better with fewer side effects over the

> long term.

>

> Studies that have looked at heart problems have shown that Gleevec

> does not cause any more heart problems than you would expect to see

> in the general population.

>

> Dasatinib (Sprycel) is effective in all stages of disease and is

well

> tolerated. Cytopenias (low blood counts) are a common side effect

> and pleural effusions can occur in 25-30% of patients but it can be

> managed. Giving 100mg once daily is showing equal responses as the

> 70mg twice daily dose and there's less side effects with the 100 mg

> dose.

>

> Nilotinib (Tasigna) is also showing to be very effective and well

> tolerated in patients who are taking it in clinical trials. It has

> shown no pleural effusions but can sometimes cause liver enzymes to

> rise.

>

> We continue to be excited about CML therapy as more hopeful drugs

are

> on the horizon. SKI-606 and INNO-406 are showing encouraging

> responses in trials so far.

>

> With so many drugs to chose from, there will soon be a question as

to

> how to select a drug to use. Side effects should be considered

when

> choosing a drug. Various mutations are better targeted with some

> drugs over others so that's another consideration to look at.

>

> 40%-60% of patients who fail imatinib have a mutation but most of

> those mutations can be managed with one of the other second or

third

> generation drugs. MK-0457 is showing activity against the more

> serious T315I mutation, which is encouraging.

>

> We want to eliminate the last leukemia cell, the " mother cell " so

> that we can cure CML. We have had a significant amount of success

in

> treating CML but we still have a way to go to cure it. We are

> hopeful for a cure in the " very near future " .

>

> Clinical trials are essential for gaining knowledge so it's

> important that patients continue to participate in trials if they

> can.

>

> Advances in CML have been very quick. We now have 3 generations of

> inhibitors to chose from.

>

[Guest guest]

Thank you Tracey for the notes, that is very kind of you. On the serum level

question I had it tested by my hemato in Paris as part of one of their

clinical trial, as I am close to but not quite MMR, although I was CCR in 12

month. It turned out I had a rather low level but not below acceptable. So

the question to raise the dose of gleevec was a tricky one. As the PCR is

still slowly going down and I am not too willing to give quality of life

without sharp reasons I am staying on 400mg for now. The drs still need some

time to learn how to best use the new tool.

I had an amazing dive Saturday, that's not going to make me willing to give

up deep diving

Marcos.

On 9/20/07, Tracey <traceyincanada@...> wrote:

>

> Hi Everyone,

>

> In case any of you weren't able to listen to today's teleconference

> but were interested in what Dr. Cortes said, I've written a summary

> in two parts. This post will look at his initial " lecture " and my

> next post will have the question/answer period.

>

> He started with a brief history of CML saying that it was the first

> malignancy where a chromosomal change was found to cause a disease.

> Past goals of CML therapy were simply to control blood counts but

> thanks to Gleevec and other targeted therapies, our goal now is to

> reach the source of the disease and allow patients to live long term.

>

> Between the years of 1997-2007 there hasn't been much of a change in

> the number of people being diagnosed with CML. Prior to 1997, 2400

> patients died a year from CML and now there are less than 500

> patients dying a year due to CML.

>

> Survival has gone from 3-4 years prior to Gleevec, to now 95% of

> patients are still alive after 5 years. The IRIS trial has shown us

> that more than 80% of newly diagnosed patients have achieved a CCR

> which has been very durable over 5 years. The longer the patients

> are on Gleevec, the lower the rates of relapse are, which is very

> encouraging.

>

> He said that blood levels of Imatinib (Gleevec) can predict the level

> of response a patient will have. Low concentrations of imatinib in

> the blood, don't give patients as good of a response as higher

> levels. He also said that serum testing of Gleevec is now widely

> available.

>

> The earlier the patient responds, the better the outcome. Patients

> who are in CCR at 1 year, have the best probability of a durable

> response. He mentioned that proper monitoring of disease is

> essential. FISH tests can have a false positive rate of up to 10% so

> that should be taken into consideration when evaluating a patients

> results.

>

> A PCR test measures the patient's molecular response. A major

> molecular response (MMR) is a 3 log reduction. Each lab has a

> baseline value of what a newly diagnosed patient will have in terms

> of a PCR result. If for instance, the baseline is 50, then a one log

> reduction would be 5, a two log reduction would be 0.5, and a three

> log reduction would be 0.05.

>

> Standard dose Imatinib has shown wonderful responses but higher dose

> therapy can show faster and even deeper responses. He mentioned

> though that higher dose therapy (800mg) is still considered

> investigational, it's not by any means standard.

>

> Over the long term, side effects appear to ease up in most patients.

> We used to be concerned about the long term effects of taking Gleevec

> but after 5 years of use, we're not so worried anymore because people

> seem to be doing better and better with fewer side effects over the

> long term.

>

> Studies that have looked at heart problems have shown that Gleevec

> does not cause any more heart problems than you would expect to see

> in the general population.

>

> Dasatinib (Sprycel) is effective in all stages of disease and is well

> tolerated. Cytopenias (low blood counts) are a common side effect

> and pleural effusions can occur in 25-30% of patients but it can be

> managed. Giving 100mg once daily is showing equal responses as the

> 70mg twice daily dose and there's less side effects with the 100 mg

> dose.

>

> Nilotinib (Tasigna) is also showing to be very effective and well

> tolerated in patients who are taking it in clinical trials. It has

> shown no pleural effusions but can sometimes cause liver enzymes to

> rise.

>

> We continue to be excited about CML therapy as more hopeful drugs are

> on the horizon. SKI-606 and INNO-406 are showing encouraging

> responses in trials so far.

>

> With so many drugs to chose from, there will soon be a question as to

> how to select a drug to use. Side effects should be considered when

> choosing a drug. Various mutations are better targeted with some

> drugs over others so that's another consideration to look at.

>

> 40%-60% of patients who fail imatinib have a mutation but most of

> those mutations can be managed with one of the other second or third

> generation drugs. MK-0457 is showing activity against the more

> serious T315I mutation, which is encouraging.

>

> We want to eliminate the last leukemia cell, the " mother cell " so

> that we can cure CML. We have had a significant amount of success in

> treating CML but we still have a way to go to cure it. We are

> hopeful for a cure in the " very near future " .

>

> Clinical trials are essential for gaining knowledge so it's

> important that patients continue to participate in trials if they

> can.

>

> Advances in CML have been very quick. We now have 3 generations of

> inhibitors to chose from.

>

>

>

--

Marcos Perreau Guimaraes

Suppes Brain Lab

Ventura Hall - CSLI

Stanford University

220 Panama street

Stanford CA 94305-4101

650 614 2305

650 630 5015 (cell)

marcospg@...

montereyunderwater@...

www.stanford.edu/~marcospg/

[Guest guest]

Hi Marcos,

I understand your dilemma and I want you to know that it is very very

common for people to reach MMR later on in their treatment. The

longer a person stays on Gleevec, the greater their response is. It

wouldn't surprise me at all if after another year (or maybe even

less), you hit that holy grail of a MMR response. I know people who

took over 4 years to get there but what matters is that they were

stable during the time they were " working on it " . If your PCR's are

consistent, there isn't much cause for concern just because you're

not at MMR yet. Like they say, patience is a virtue

Take care and happy diving,

Tracey

dx Jan 2002

400mg Gleevec Feb 2002

-- In , " Marcos Perreau Guimaraes "

<montereyunderwater@...> wrote:

>

> Thank you Tracey for the notes, that is very kind of you. On the

serum level

> question I had it tested by my hemato in Paris as part of one of

their

> clinical trial, as I am close to but not quite MMR, although I was

CCR in 12

> month. It turned out I had a rather low level but not below

acceptable. So

> the question to raise the dose of gleevec was a tricky one. As the

PCR is

> still slowly going down and I am not too willing to give quality of

life

> without sharp reasons I am staying on 400mg for now. The drs still

need some

> time to learn how to best use the new tool.

> I had an amazing dive Saturday, that's not going to make me willing

to give

> up deep diving

> Marcos.

>

>

> On 9/20/07, Tracey <traceyincanada@...> wrote:

> >

> > Hi Everyone,

> >

> > In case any of you weren't able to listen to today's

teleconference

> > but were interested in what Dr. Cortes said, I've written a

summary

> > in two parts. This post will look at his initial " lecture " and my

> > next post will have the question/answer period.

> >

> > He started with a brief history of CML saying that it was the

first

> > malignancy where a chromosomal change was found to cause a

disease.

> > Past goals of CML therapy were simply to control blood counts but

> > thanks to Gleevec and other targeted therapies, our goal now is to

> > reach the source of the disease and allow patients to live long

term.

> >

> > Between the years of 1997-2007 there hasn't been much of a change

in

> > the number of people being diagnosed with CML. Prior to 1997, 2400

> > patients died a year from CML and now there are less than 500

> > patients dying a year due to CML.

> >

> > Survival has gone from 3-4 years prior to Gleevec, to now 95% of

> > patients are still alive after 5 years. The IRIS trial has shown

us

> > that more than 80% of newly diagnosed patients have achieved a CCR

> > which has been very durable over 5 years. The longer the patients

> > are on Gleevec, the lower the rates of relapse are, which is very

> > encouraging.

> >

> > He said that blood levels of Imatinib (Gleevec) can predict the

level

> > of response a patient will have. Low concentrations of imatinib in

> > the blood, don't give patients as good of a response as higher

> > levels. He also said that serum testing of Gleevec is now widely

> > available.

> >

> > The earlier the patient responds, the better the outcome. Patients

> > who are in CCR at 1 year, have the best probability of a durable

> > response. He mentioned that proper monitoring of disease is

> > essential. FISH tests can have a false positive rate of up to 10%

so

> > that should be taken into consideration when evaluating a patients

> > results.

> >

> > A PCR test measures the patient's molecular response. A major

> > molecular response (MMR) is a 3 log reduction. Each lab has a

> > baseline value of what a newly diagnosed patient will have in

terms

> > of a PCR result. If for instance, the baseline is 50, then a one

log

> > reduction would be 5, a two log reduction would be 0.5, and a

three

> > log reduction would be 0.05.

> >

> > Standard dose Imatinib has shown wonderful responses but higher

dose

> > therapy can show faster and even deeper responses. He mentioned

> > though that higher dose therapy (800mg) is still considered

> > investigational, it's not by any means standard.

> >

> > Over the long term, side effects appear to ease up in most

patients.

> > We used to be concerned about the long term effects of taking

Gleevec

> > but after 5 years of use, we're not so worried anymore because

people

> > seem to be doing better and better with fewer side effects over

the

> > long term.

> >

> > Studies that have looked at heart problems have shown that Gleevec

> > does not cause any more heart problems than you would expect to

see

> > in the general population.

> >

> > Dasatinib (Sprycel) is effective in all stages of disease and is

well

> > tolerated. Cytopenias (low blood counts) are a common side effect

> > and pleural effusions can occur in 25-30% of patients but it can

be

> > managed. Giving 100mg once daily is showing equal responses as the

> > 70mg twice daily dose and there's less side effects with the 100

mg

> > dose.

> >

> > Nilotinib (Tasigna) is also showing to be very effective and well

> > tolerated in patients who are taking it in clinical trials. It has

> > shown no pleural effusions but can sometimes cause liver enzymes

to

> > rise.

> >

> > We continue to be excited about CML therapy as more hopeful drugs

are

> > on the horizon. SKI-606 and INNO-406 are showing encouraging

> > responses in trials so far.

> >

> > With so many drugs to chose from, there will soon be a question

as to

> > how to select a drug to use. Side effects should be considered

when

> > choosing a drug. Various mutations are better targeted with some

> > drugs over others so that's another consideration to look at.

> >

> > 40%-60% of patients who fail imatinib have a mutation but most of

> > those mutations can be managed with one of the other second or

third

> > generation drugs. MK-0457 is showing activity against the more

> > serious T315I mutation, which is encouraging.

> >

> > We want to eliminate the last leukemia cell, the " mother cell " so

> > that we can cure CML. We have had a significant amount of success

in

> > treating CML but we still have a way to go to cure it. We are

> > hopeful for a cure in the " very near future " .

> >

> > Clinical trials are essential for gaining knowledge so it's

> > important that patients continue to participate in trials if they

> > can.

> >

> > Advances in CML have been very quick. We now have 3 generations of

> > inhibitors to chose from.

> >

> >

> >

>

>

>

> --

> Marcos Perreau Guimaraes

> Suppes Brain Lab

> Ventura Hall - CSLI

> Stanford University

> 220 Panama street

> Stanford CA 94305-4101

> 650 614 2305

> 650 630 5015 (cell)

> marcospg@...

> montereyunderwater@...

> www.stanford.edu/~marcospg/

>

>

>

[Guest guest]

It was my pleasure Lynn. I hope you see a relief soon in those side

effects. If not, you know that there are other drugs right around

the corner. You will always have options which is such a nice thing

to have.

Take care,

Tracey

> >

> > Hi Everyone,

> >

> > In case any of you weren't able to listen to today's

teleconference

> > but were interested in what Dr. Cortes said, I've written a

summary

> > in two parts. This post will look at his initial " lecture " and

my

> > next post will have the question/answer period.

> >

> > He started with a brief history of CML saying that it was the

first

> > malignancy where a chromosomal change was found to cause a

> disease.

> > Past goals of CML therapy were simply to control blood counts but

> > thanks to Gleevec and other targeted therapies, our goal now is

to

> > reach the source of the disease and allow patients to live long

> term.

> >

> > Between the years of 1997-2007 there hasn't been much of a change

> in

> > the number of people being diagnosed with CML. Prior to 1997,

2400

> > patients died a year from CML and now there are less than 500

> > patients dying a year due to CML.

> >

> > Survival has gone from 3-4 years prior to Gleevec, to now 95% of

> > patients are still alive after 5 years. The IRIS trial has shown

> us

> > that more than 80% of newly diagnosed patients have achieved a

CCR

> > which has been very durable over 5 years. The longer the

patients

> > are on Gleevec, the lower the rates of relapse are, which is very

> > encouraging.

> >

> > He said that blood levels of Imatinib (Gleevec) can predict the

> level

> > of response a patient will have. Low concentrations of imatinib

in

> > the blood, don't give patients as good of a response as higher

> > levels. He also said that serum testing of Gleevec is now widely

> > available.

> >

> > The earlier the patient responds, the better the outcome.

Patients

> > who are in CCR at 1 year, have the best probability of a durable

> > response. He mentioned that proper monitoring of disease is

> > essential. FISH tests can have a false positive rate of up to

10%

> so

> > that should be taken into consideration when evaluating a

patients

> > results.

> >

> > A PCR test measures the patient's molecular response. A major

> > molecular response (MMR) is a 3 log reduction. Each lab has a

> > baseline value of what a newly diagnosed patient will have in

terms

> > of a PCR result. If for instance, the baseline is 50, then a one

> log

> > reduction would be 5, a two log reduction would be 0.5, and a

three

> > log reduction would be 0.05.

> >

> > Standard dose Imatinib has shown wonderful responses but higher

> dose

> > therapy can show faster and even deeper responses. He mentioned

> > though that higher dose therapy (800mg) is still considered

> > investigational, it's not by any means standard.

> >

> > Over the long term, side effects appear to ease up in most

> patients.

> > We used to be concerned about the long term effects of taking

> Gleevec

> > but after 5 years of use, we're not so worried anymore because

> people

> > seem to be doing better and better with fewer side effects over

the

> > long term.

> >

> > Studies that have looked at heart problems have shown that

Gleevec

> > does not cause any more heart problems than you would expect to

see

> > in the general population.

> >

> > Dasatinib (Sprycel) is effective in all stages of disease and is

> well

> > tolerated. Cytopenias (low blood counts) are a common side

effect

> > and pleural effusions can occur in 25-30% of patients but it can

be

> > managed. Giving 100mg once daily is showing equal responses as

the

> > 70mg twice daily dose and there's less side effects with the 100

mg

> > dose.

> >

> > Nilotinib (Tasigna) is also showing to be very effective and well

> > tolerated in patients who are taking it in clinical trials. It

has

> > shown no pleural effusions but can sometimes cause liver enzymes

to

> > rise.

> >

> > We continue to be excited about CML therapy as more hopeful drugs

> are

> > on the horizon. SKI-606 and INNO-406 are showing encouraging

> > responses in trials so far.

> >

> > With so many drugs to chose from, there will soon be a question

as

> to

> > how to select a drug to use. Side effects should be considered

> when

> > choosing a drug. Various mutations are better targeted with some

> > drugs over others so that's another consideration to look at.

> >

> > 40%-60% of patients who fail imatinib have a mutation but most of

> > those mutations can be managed with one of the other second or

> third

> > generation drugs. MK-0457 is showing activity against the more

> > serious T315I mutation, which is encouraging.

> >

> > We want to eliminate the last leukemia cell, the " mother cell " so

> > that we can cure CML. We have had a significant amount of

success

> in

> > treating CML but we still have a way to go to cure it. We are

> > hopeful for a cure in the " very near future " .

> >

> > Clinical trials are essential for gaining knowledge so it's

> > important that patients continue to participate in trials if

they

> > can.

> >

> > Advances in CML have been very quick. We now have 3 generations

of

> > inhibitors to chose from.

> >

>

[Guest guest]

Hi ,

One thing I have learned over the years is that even the top experts

will sometimes disagree on things. Maybe " disagree " isn't the right

word, maybe I should say that they have " different ideas " .

Deciding when or if to do BMB's regularly is a perfect example. Some

of the top experts believe that it's still important to do them with

relative regularity and others believe that they aren't at all

necessary for people who are in CCR.

Another thought that comes to my mind in terms of mutations is that

it seems reasonable to me to think that there are probably mutations

out there that exist but haven't yet been identified. In other

words, just because a mutation isn't found in someone, doesn't mean

to me that one doesn't exist. Kind of like people who are

PCRU....it's not that they don't have any cancer cells but rather

that none were found in that sample with that test.

I know I'm not helping much with the question at hand...if someone

doesn't have any identifiable mutations, but isn't responding

adequately to either Gleevec or Sprycel, does that mean they should

go straight to transplant or should they explore other drugs.

Personally, I don't think there is a right or wrong answer to that.

Tracey

> >> > Hi

Everyone,> > > > In case any of you weren't able to listen to today's

teleconference > > but were interested in what Dr. Cortes said, I've

written a summary > > in two parts. This post will look at his

initial " lecture " and my > > next post will have the question/answer

period.> > > > He started with a brief history of CML saying that it

was the first > > malignancy where a chromosomal change was found to

cause a > disease. > > Past goals of CML therapy were simply to

control blood counts but > > thanks to Gleevec and other targeted

therapies, our goal now is to > > reach the source of the disease and

allow patients to live long > term.> > > > Between the years of 1997-

2007 there hasn't been much of a change > in > > the number of people

being diagnosed with CML. Prior to 1997, 2400 > > patients died a

year from CML and now there are less than 500 > > patients dying a

year due to CML.> > > > Survival has gone from 3-4 years prior to

Gleevec, to now 95% of > > patients are still alive after 5 years.

The IRIS trial has shown > us > > that more than 80% of newly

diagnosed patients have achieved a CCR > > which has been very

durable over 5 years. The longer the patients > > are on Gleevec, the

lower the rates of relapse are, which is very > > encouraging.> > > >

He said that blood levels of Imatinib (Gleevec) can predict the >

level > > of response a patient will have. Low concentrations of

imatinib in > > the blood, don't give patients as good of a response

as higher > > levels. He also said that serum testing of Gleevec is

now widely > > available.> > > > The earlier the patient responds,

the better the outcome. Patients > > who are in CCR at 1 year, have

the best probability of a durable > > response. He mentioned that

proper monitoring of disease is > > essential. FISH tests can have a

false positive rate of up to 10% > so > > that should be taken into

consideration when evaluating a patients > > results.> > > > A PCR

test measures the patient's molecular response. A major > > molecular

response (MMR) is a 3 log reduction. Each lab has a > > baseline

value of what a newly diagnosed patient will have in terms > > of a

PCR result. If for instance, the baseline is 50, then a one > log > >

reduction would be 5, a two log reduction would be 0.5, and a three >

> log reduction would be 0.05.> > > > Standard dose Imatinib has

shown wonderful responses but higher > dose > > therapy can show

faster and even deeper responses. He mentioned > > though that higher

dose therapy (800mg) is still considered > > investigational, it's

not by any means standard.> > > > Over the long term, side effects

appear to ease up in most > patients. > > We used to be concerned

about the long term effects of taking > Gleevec > > but after 5 years

of use, we're not so worried anymore because > people > > seem to be

doing better and better with fewer side effects over the > > long

term.> > > > Studies that have looked at heart problems have shown

that Gleevec > > does not cause any more heart problems than you

would expect to see > > in the general population.> > > > Dasatinib

(Sprycel) is effective in all stages of disease and is > well > >

tolerated. Cytopenias (low blood counts) are a common side effect > >

and pleural effusions can occur in 25-30% of patients but it can be >

> managed. Giving 100mg once daily is showing equal responses as the

> > 70mg twice daily dose and there's less side effects with the 100

mg > > dose.> > > > Nilotinib (Tasigna) is also showing to be very

effective and well > > tolerated in patients who are taking it in

clinical trials. It has > > shown no pleural effusions but can

sometimes cause liver enzymes to > > rise.> > > > We continue to be

excited about CML therapy as more hopeful drugs > are > > on the

horizon. SKI-606 and INNO-406 are showing encouraging > > responses

in trials so far.> > > > With so many drugs to chose from, there will

soon be a question as > to > > how to select a drug to use. Side

effects should be considered > when > > choosing a drug. Various

mutations are better targeted with some > > drugs over others so

that's another consideration to look at.> > > > 40%-60% of patients

who fail imatinib have a mutation but most of > > those mutations can

be managed with one of the other second or > third > > generation

drugs. MK-0457 is showing activity against the more > > serious T315I

mutation, which is encouraging.> > > > We want to eliminate the last

leukemia cell, the " mother cell " so > > that we can cure CML. We have

had a significant amount of success > in > > treating CML but we

still have a way to go to cure it. We are > > hopeful for a cure in

the " very near future " .> > > > Clinical trials are essential for

gaining knowledge so it's > > important that patients continue to

participate in trials if they > > can.> > > > Advances in CML have

been very quick. We now have 3 generations of > > inhibitors to chose

from.> >>

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