Hi John,

I am sorry to hear that you are having such a rough time.

There are several drugs currently in the pipeline at various stages of development. Some are only for CML patients with the T315I mutation which you obviously do not have. The one with the most promise that you might want to consider is Ariad's "AP24534". That is what I am presently taking. It is a very powerful pan-BCR-ABL inhibitor. It kills every CML break-point mutation they have tested it against in the lab, including the T315I mutation which none of the other FDA approved TKIs will even touch. It has finished Phase I recruiting and is scheduled to begin Phase II trials in late summer or early fall of this year. Knowing what I know about trial starting dates, I doubt if the Phase II will begin on time. My guess is that we will be lucky to see it start this year. AP24534 is not without side effects. I have a rash, substantial joint and muscle pain, fatigue and blister like bumps that are very sore and come and go on my hands. However, I am on the maximum dose, 45mg daily. This drug is very powerful and I know patients on much lower doses down to 15 mg and lower that are being controlled and even PCRU. One of my friends is PCRU on 15 milligrams and has virtually no side effects. Of course, as you well know, one cannot make assumptions on how you will react to this drug based on the reaction of others. At this time, this is the only drug, that I know about, that is anywhere near phase II trials that would be an option for you. Dr. Talpaz is very excited about AP24534. It has a good chance of becoming the front line therapy for CML if the trials continue to bear out its efficacy and safety.

Regards,
Jerry