Interview with Dr. Jane Apperley

[Guest guest]

http://www.oncologystat.com/viewpoints/when-the-smoke-clears/CML_New_Drugs_P

art_I_Interview_With_Dr_Jane_Apperley.html

Follow the links. There are two excellent interviews with Dr. Jane Apperley.

CML-The Changing Landscape of Front-line Therapy: Part I: Interview With Dr.

Jane Apperley

OncologySTAT Editorial Team. 2010 Nov 23, Interview by L Zoeller

CML-What to do About Imatinib Resistance; When to Consider Transplant: Part

II: Interview With Dr. Jane Apperley

OncologySTAT Editorial Team. 2010 Nov 23, Interview by L Zoeller

Zavie

Zavie (age 72)

67 Shoreham Avenue

Ottawa, Canada, K2G 3X3

dxd AUG/99

INF OCT/99 to FEB/00, CHF

No meds FEB/00 to JAN/01

Gleevec since MAR/27/01 (400 mg)

CCR SEP/01. #102 in Zero Club

2.8 log reduction Sep/05

3.0 log reduction Jan/06

2.9 log reduction Feb/07

3.6 log reduction Apr/08

3.6 log reduction Sep/08

3.7 log reduction Jan/09

3.8 log reduction May/09

3.8 log reduction Aug/09

4.0 log reduction Dec/09

4.4 log reduction Apr/10

4.3 log reduction Oct/10

e-mail: <mailto:zmiller@...> zmiller@...

Tel: 613-726-1117

Fax: 613-482-4801

Cell: 613-282-0204

ID: zaviem

[Guest guest]

Hi Zavie,

First a tech point - the link you posted is not a good one. Perhaps this will

work better:

http://www.oncologystat.com/viewpoints/when-the-smoke-clears/CML_New_Drugs_Part_\

I_Interview_With_Dr_Jane_Apperley.html

(if the test does not show all blue one must copy the whole text and paste into

your browser line)

Very interesting pair of articles. A few items that piqued my interest:

1) her position that imatinib will remain the first line therapy for a long time

(basically the position that we know it the best and longest). This seems to

contradict what we are hearing from our US specialists, Dr Cortes et al, who

seem to be leaning towards using the second generation of drugs as first line

therapy

2) her position that the standard dose of imatinib (400mg) is too low, and that

patients should really be at 600-800mg, despite the high level of side effects.

I had thought that the side by side study of high dose vs standard dose of

imatinib showed that any short term benefit, of reaching milestones quicker (to

those that could tolerate the higher dose), was evened out by 2 years into the

study (am I remembering correctly?)

3) that 40% (!!!!!!) of patients are not fully compliant in taking their meds. I

find that astonishing. Perhaps this is a result of CML now being perceived as a

non-fatal disease, manageable disease?

I have never been treated by a doctor who advocated occasional drug holidays (is

this something that is/was more widespread in the UK?). The only " holidays " I

ever had were due to severe side effects, and everyone was quite clear that I

should be back on meds ASAP. While I was relieved to have a break from having

the drugs in my system, I was always aware that CML was going to come back...

On the same issue - most of us are aware that a single PCR jump is not a reason

to change treatment, and may be a lab glitch, so one needs to see a trend. I

have never heard a doctor express that they are skeptical that it indicated

losing a response, because it might just be due to missing doses.

Always interesting to see what different folks think. I am always grateful, in

these situations, that I am being cared for by Dr. Druker. I never have to

wonder if I am more informed than him ;-)

Leah

>

> http://www.oncologystat.com/viewpoints/when-the-smoke-clears/CML_New_Drugs_P

> art_I_Interview_With_Dr_Jane_Apperley.html

>

>

>

> Follow the links. There are two excellent interviews with Dr. Jane Apperley.

>

>

>

> CML-The Changing Landscape of Front-line Therapy: Part I: Interview With Dr.

> Jane Apperley

>

> OncologySTAT Editorial Team. 2010 Nov 23, Interview by L Zoeller

>

>

> CML-What to do About Imatinib Resistance; When to Consider Transplant: Part

> II: Interview With Dr. Jane Apperley

>

>

> OncologySTAT Editorial Team. 2010 Nov 23, Interview by L Zoeller

>

>

> Zavie

>

>

>

> Zavie (age 72)

>

> 67 Shoreham Avenue

>

> Ottawa, Canada, K2G 3X3

>

> dxd AUG/99

>

> INF OCT/99 to FEB/00, CHF

>

> No meds FEB/00 to JAN/01

>

> Gleevec since MAR/27/01 (400 mg)

>

> CCR SEP/01. #102 in Zero Club

>

> 2.8 log reduction Sep/05

>

> 3.0 log reduction Jan/06

>

> 2.9 log reduction Feb/07

>

> 3.6 log reduction Apr/08

>

> 3.6 log reduction Sep/08

>

> 3.7 log reduction Jan/09

>

> 3.8 log reduction May/09

>

> 3.8 log reduction Aug/09

>

> 4.0 log reduction Dec/09

>

> 4.4 log reduction Apr/10

>

> 4.3 log reduction Oct/10

>

> e-mail: <mailto:zmiller@...> zmiller@...

>

> Tel: 613-726-1117

>

> Fax: 613-482-4801

>

> Cell: 613-282-0204

>

> ID: zaviem

>

>

>

>

>

>