Questions for Dr. Mauro at the NCMLS Event

Every now and then you run across someone that goes the extra mile. It appears that Dr. Michael Mauro is one of those guys. He will be answering questions at the CML Connection, in New York City on March 21, 2013.

The questions that I submitted are probably already on the list and may sound a bit confusing, but here they are:

One of my questions, and I won't be surprised that it is already on the list is this:

1. Given there are 3 options of treatment, Gleevec, Tasigna and Sprycel how does one determine the best frontline option?

I realize that patients existing medical history may play into this decision but I would like to know, that if a patient is otherwise healthy, which would be the best choice, and why?

My next questions:

2. Is there any data that would support a patient going off of a TKI, after reaching a negative response and then beginning treatment again, when their PCR rose to a certain point, kind of cyclically? In other words; take long breaks in between treatment, allowing an increase in BCR-ABL to increase and then treating it again?

As we all know, patients are diagnosed at all different levels of the disease, some with a low white count others with a very high white count, but both scenarios seem to be treatable. I guess I am wondering if one could live medication free, for a good part of the time and only be on treatment when the disease began to enter into a more dangerous phase. Kind of like treating a bacterial infection, not preventing one?

3. Does CML, or the use of a TKI make us more prone to other cancers? It seems that there are so many people on our CML boards that have other cancers, too.

4. Why aren't patients dosed by weight?

I will let you all of know the answers when I receive them!

Thank you Lynne Dagata for hosting!