It’s not always a simple matter to get access to the medications you need, but a delay in starting treatment for CML can jeopardize the success of therapy. This was shown in a recent study conducted in Bosnia, where people often face considerable red tape before they can start a TKI such as Gleevec, Sprycel or Tasigna.
Researchers in that country looked at treatment starts to see if delays had an impact on outcomes (Kurtovic-Kozaric and colleagues. Br J Haematol 2015; epublished November 11, 2015). Overall, two-thirds of people with CML had to wait a median of 14 months before starting therapy. Only 16% started a TKI in the first three months after being diagnosed.
In the group who started Gleevec right away, two-thirds achieved a complete cytogenetic response (CCyR) in the first year, compared to 18% of those who started 6-12 months after diagnosis, and 15% of those who had to wait over a year for treatment. Ten percent of people starting treatment right away achieved a major molecular response (MMR; or a 3-log reduction) in the first year. No one achieved MMR if they didn’t get prompt access to the drug.
Some of the problems of delayed access could be offset by starting a more potent, second-generation drug. Delaying treatment didn’t affect success rates for people taking Tasigna.