Because the appearance of such muta tions seems to indicate impending relapse

Patients who had their imatinib dose increased had significantly AP24534 VEGFR 阻害剤 worse adherence than patients who remained on imatinib 400 mg QD, In a retrospective analysis of imati nib treatment in clinical practice using US administra tive claims data, adherence to imatinib in 267 patients was calculated using the medication possession rate, ie, the total days supply of imatinib in a 1 year period divided by 365. Overall, the mean MPR was 78% and 31% of patients had a treatment interruption of at least 30 consecutive days.<br><br> Among the study population, nonadherence was higher in patients with higher num bers of concomitant medications, women, patients with more complex disease, and patients with a higher start ing dose of imatinib, Although the reasons for worse adherence in women were not examined, the authors suggested AT-406 dissolve 溶解度 that women may be more concerned than men with AEs characteristic of imatinib treatment, such as rash, edema, and weight gain, The importance of adherence to imatinib in response to treatment is further illustrated by the results of a phase 3 randomized trial of imatinib 400 mg QD vs 800 mg d in patients with newly diagnosed CP CML, Rates of MMR and CCyR at 12 months were similar between the two arms. However, treatment responses in patients from the 800 mg d arm correlated with the dose of imatinib that could be toler ated, with higher MMR rates achieved in patients with an average dose intensity of 600 mg d or higher compared with 400 599 mg d or 400 mg d, In the 400 vs 800 mg arms, 18% vs 61% of patients had a dose reduction, 52% vs 73% reported at least one day with zero dose, 38% vs 67% had dose interruption lasting longer than 5 days, and 16% vs 20% discontinued treatment.<br><br> The main reason for dose reduction in the 800 mg d arm, but not the 400 mg d arm, was AEs or laboratory abnormalities. These data suggest that the higher number of days off medication in the high dose imatinib arm counteracted any positive effect akt2 阻害剤 of higher dosing, Nonadherence is a possible cause for reduced response to imatinib and should be considered in patients with suboptimal response to imatinib, The AE profiles and tolerability of newer treatments are therefore important considerations for clinical practice in the first line setting in terms of both efficacy and safety.<br><br> Safety and tolerability of dasatinib and nilotinib compared with imatinib in the first line setting Although dasatinib and nilotinib have been available for use in therapy of CML in the second line settings for several years, new studies have provided the first direct comparison with imatinib in the first line setting. In general, imatinib, dasatinib, and nilotinib are associated with broadly similar types of AEs, although the relative occurrence of different AEs varies between agents and some AEs are specific to one drug, For best management of CML patients receiving TKI ther apy, knowledge of potential toxicities, how to avoid them, how to deal with them should they arise, and how they may affect response and outcome, are important factors.