Refractory and Relapsed
Some patients still have leukemia cells in their bone marrow after chronic myeloid leukemia (CML) treatment with the tyrosine kinase inhibitors (TKIs) Gleevec®, Tasigna® or Sprycel®. This is called refractory leukemia or drug resistance. Other patients taking a TKI may find that the drug no longer works for them, called a loss of response. If a patient's disease returns, it is called a relapse.
- Bosulif® (bosutinib) is FDA approved for patients with chronic, accelerated or blast phase Philadelphia chromosome-positive CML who are resistant to or who cannot tolerate other therapies.
- The safety and effectiveness of Bosulif was evaluated in a single clinical trial that enrolled 546 adult patients who had chronic, accelerated or blast phase CML. All patients had disease that progressed after treatment with imatinib or imatinib followed by dasatinib and/or nilotinib, or who could not tolerate the side effects of prior therapy. All patients in the trial were treated with Bosulif.
- SynriboTM (omacetaxine mepesuccinate) is FDA approved to treat adult patients with chronic phase or accelerated phase CML with resistance and/or intolerance to two or more tyrosine kinase inhibitors (TKIs). It is injected just under the skin (subcutaneously).
- The effectiveness of Synribo was evaluated using a combined group of patients whose cancer progressed after previous treatment with two or more TKIs. All participants were treated with Synribo.
- Iclusig® (ponatinib) is FDA approved for patients with chronic, accelerated, and blast phase Philadelphia chromosome-positive CML who are resistant or intolerant to other tyrosine kinase inhibitors (TKIs). Iclusig targets CML cells that have a particular mutation, known as T315I, which makes these cells resistant to other currently approved TKIs.
- The safety and effectiveness of Iclusig were evaluated in a single clinical trial of 449 patients with various phases of CML. All participants were treated with Iclusig.
If you would like to read about these drugs individually, including information about side effects, click here.
If your CML doesn't respond effectively to drug therapy, your doctor will discuss additional options such as a clinical trial or allogeneic stem cell transplantation. Other treatment choices are a second allogeneic transplant or donor lymphocyte infusion.