Dx September 2016 and started on 600 MG Tasigna. Side effects were horrendous, but my PCR was MR 4.5 in 6 months, so I reduced dose to 20 Mg over the next 6 months and became undetectable during that time. Side effects improved markedly, but some still lingered.
In June of 2020, I attempted TFR but only lasted 75 days and restarted on 20 mg Sprycel and was undetectable again in 6 months. I started to have multiple musculoskeletal issues (mostly tendinosis and mild myalgia) and mild neuropathy in 2022 which has persisted to this day and has affected my ability to be as physically active as I was prior to 2022 (I am 72 years old). So with my oncologist's blessing and increased testing intervals, I reduced my dosage to 20 mg every other day and remained undetectable for 9 months. I decided to attempt TFR again but again only lasted 74 days before I had to restart on November 2025 when my PCR hit .04%. My last test in early January was .02%, so heading in the right direction.
Assuming I reach undetectable again, I am thinking about possibly switching from dasatinib to either 50 mg bosutinib or 20 mg asciminib. My oncologist is on board with this but suggested I try bosutinib first. So I asked AI which TKI would be best for me based on the side effects profile on dasatinib and my overall health profile, which is good. Here's what AI produced:
1. Asciminib - Best Overall Fit
- Excellent musculoskeletal, pulmonary, metabolic, and vascular profile.
2. Bosutinib - Strong Fit
- Low musculoskeletal and pulmonary impact; manageable GI effects.
3. Nilotinib - Mixed Fit
- Mild musculoskeletal effects; requires metabolic monitoring.
4. Dasatinib - Caution
- Moderate musculoskeletal effects; high pulmonary risk.
5. Imatinib - Least Aligned
- High musculoskeletal burden; likely to aggravate existing issues.
I'd appreciate any thoughts that anybody might have about this, including it's accuracy and any opinions on whether or not I should switch and if so, which TKI to switch to. Thanks