In today's world, CML Survivors have a variety of therapies from which to choose. Prior to the days of Tyrosine Kinase Inhibitors (TKIs), treatments varied and included arsenic (many years ago), standard chemotherapy, Interferon, and others. There are a number of other agents in development for the treatment of CML. You can read more about them here.
Here are some of the therapies in use today:
Frontline Therapies/Tyrosine Kinase Inhibitors (TKIs):
Gleevec® (Imatinib Mesylate) - brand name for Novartis’ anti-CML drug, STI 571. Gleevec works by binding to and inhibiting the bcr-abl enzyme that is the hallmark of this disease. Gleevec’s generic name is imatinib mesylate, and may also be referred to as IM in written form. Approved for frontline therapy of chronic phase CML in May 2001. [Novartis]
Sprycel® (Dasatinib) - The branded name of Dasatinib from Bristol Myers Squibb. Approved for frontline therapy of chronic phase CML October 2010. [Bristol-Myers Squibb]
Tasigna® (Nilotinib) - The branded name of Nilotinib from Novartis. Approved for frontline therapy of chronic phase CML June 2010. [Novartis]
Bosulif® (Bosutinib) (formerly known as SKI-606) - Bosutinib is a third generation tyrosine kinase inhibitor. It has been useful in patients whose leukemia is resistant to both first and second generation tyrosine kinase inhibitors. It is a dual kinase inhibitor. Unlike imatinib, bosutinib inhibits the autophosphorylation of both Abl and Src kinases, resulting in inhibition of cell growth and apoptosis (cell death). Approved for CML in chronic, accelerated, or blast phase in patients resistant or intolerant to prior therapy September 2012. [Pfizer]
Therapies for resistant disease, following TKI failure, or difficult cases compounded by mutations:
Synribo® (Omacetaxine Mepusuccinate) - Synribo is approvide for use in adult patients with two or more incidences of resistance or intolerance to previous therapies (tyrosine kinase inhibitors) It is injected subcutaneously and is effective in patients with multiple tyrosine kinase inhibitor failures, as well as those with the T315I mutation. Approval of Synribo was based on the response rates of individuals participating in the trials who were in either chronic or accelerated phase. The data related to longterm survival is still being accrued. [Teva Oncology]
Iclusig® (Ponatinib) - The branded name of AP24534 formerly from Ariad Pharmaceuticals - acquired by Takeda in 2017. Ponatinib is a Pan BCR-ABL inhibitor and has a different mechanism of action from the tyrosine kinase inhibitors shown above. This agent not only effectively binds to BCR ABL and inhibits its function, it is also effective in treating the T315I Mutation. [Takeda]
Therapies that have previously been utilized, but not generally used in a frontline setting:
Cytarabine (a.k.a. Ara-C)
Marrow, Blood Stem Cell, or Cord Blood Transplant - A bone marrow or cord blood transplant (also called a BMT) using stem cells from a related or unrelated donor is the only known treatment that can bring a long-term remission from CML. These types of transplants are called allogeneic transplants. Another type of transplant, called an autologous transplant, uses a patient's own cells. Autologous transplants are rarely used to treat CML.
To find additional information on these drugs and more, visit the National Institutes of Health's Drug Information Portal
Click here to search the US Food and Drug Administration's FDA Approved Drugs.
Click here to learn more about the History of Gleevec and other therapies.
*These drugs are currently in various stages of clinical trials and are not yet approved by the FDA for mainstream usage in the treatment of CML.