Recent developments in treating cancer have made significant progress in improving treatment results of patients that suffer from certain genetic abnormalities. The most notable achievement in this area is targeted therapy of Philadelphia chromosome-positive leukemias, especially Chronic Myeloid Leukemia (CML). The new medications, such as Dasatinib, changed the treatment of the disease by targeting the actual problem instead of simply fighting dividing cells.
What is Chronic Myeloid Leukemia (CML)?
Chronic Myeloid Leukemia is cancer in which the disease manifests itself in bone marrow by causing the production of excess white blood cells. CML develops slowly in the majority of cases, and it can normally be detected through blood testing. It is associated with the presence of a particular genetic change referred to as the Philadelphia chromosome.
What Are The Symptoms of Chronic Myeloid Leukemia?
During its early onset, there may be no recognizable symptoms in CML. However, as the disease advances, some of the symptoms that may be encountered include:
- Fatigue
- Weight loss
- Night sweats
- Fever
- Swollen spleen
- Bleeding
What Is Philadelphia Chromosome-Positive Leukemia?
Philadelphia chromosome positive leukemia refers to one of the many forms of leukemia caused by a particular genetic anomaly referred to as the Philadelphia chromosome. The creation of this genetic anomaly results from a chromosomal rearrangement involving chromosomes 9 and 22, through a process referred to as translocation. Due to this phenomenon, a new gene referred to as BCR-ABL1 is created, producing an abnormal protein that leads to the proliferation of cancer cells.
How Does the BCR-ABL1 Pathway Work?
The protein BCR-ABL1 works as an enzyme, namely a continuously active tyrosine kinase enzyme that stays turned on all the time. This condition is associated with cell growth and proliferation that happens constantly and abnormally, inhibition of apoptosis process, as well as accumulation of abnormal white blood cells in the body. All these changes create problems with the production of blood cells that results in the development of chronic myeloid leukemia. That is why modern treatments focus on blocking this protein, helping to slow down cancer growth and control the disease.
How Have Tyrosine Kinase Inhibitors (TKIs) Evolved?
The Tyrosine Kinase Inhibitors (TKIs) are medication that were created with the intention of inhibiting the BCR-ABL1 protein that leads to the proliferation of cancerous cells in CML. Due to their improved performance in recent times, these drugs have been more effective in controlling the disease and reducing its resistance that results in patients’ well-being.
What Is Dasatinib?
This medicine is a second generation tyrosine kinase inhibitor for the treatment of Ph+ leukemias such as CML and some variants of acute lymphoblastic leukemia (ALL). It is indicated when:
- The patients are newly diagnosed with CML or AML
- Resistance or intolerance to other TKIs
How Does The Medicine Work?
Dasatinib works against the BCR-ABL1 protein and other kinases that are responsible for the growth of cancer cells. It works through:
- Reducing the proliferation of cancer cells.
- Lowering the amount of cancerous cells.
- Enhancing the effectiveness of the treatment.
This is a highly targeted method as compared to the general one used in chemotherapy.
What Are The Possible Side Effects Caused By The Medicine?
This medicine can have certain side effects like any other medication, but not all patients may experience them. However, visit the doctor if any of these symptoms persist or worsen:
- Nausea
- Fatigue
- Headache
- Diarrhea
- Skin rash
- Low blood cell counts
- Fluid retention
- Bleeding complications
Why Is Monitoring Important During Treatment?
This will ensure that the treatment is safe and effective. The doctors may suggest:
- Blood test
- Molecular test for BCR-ABL1 level
- Tests of liver function
- Clinical evaluation
This will help in making changes to the treatment as required.
Which Brands of The Medicine Are Available?
It comes in several brands, as well as various dosages:
- DASACINE 50 mg
- SPRYCEL 50 mg
- SPNIB 50 mg
- SPRYCEL 70 mg
- SPNIB 70 mg
The best choice for the patient will depend on their health status and doctors’ advice.
How Does Dasatinib Interact with Other Medicines?
There are some other medications that may interfere with the effect of Dasatinib on the health. Such medications as:
- Antacids
- Acid reducers
- Antibiotics and antifungals
- Blood thinners
- Herbal medicines
Always consult your physician about the drug intake.
Conclusion
The use of targeted therapies has greatly increased the success in treating patients suffering from Philadelphia positive leukemia by addressing the underlying molecular cause of the disease. Through proper monitoring, patients will be able to live healthily with this disease.
FAQs
1. Which individuals can take this therapy?
The medication is normally administered to patients diagnosed with Philadelphia chromosome positive CML or ALL. There are several criteria that determine whether one qualifies for the drug. These include the status of the disease, previous therapies, and general medical condition as determined by a doctor.
2. Is the medicine used as a first-line treatment?
Yes, it can be used as a first-line treatment in some CML cases.
References
- Kurzrock, R., Gutterman, J. U., & Talpaz, M. (1988). The molecular genetics of Philadelphia chromosome–positive leukemias. New England Journal of Medicine, 319(15), 990-998. https://pubmed.ncbi.nlm.nih.gov/3047582/
- Sawyers, C. L. (1999). Chronic myeloid leukemia. New England Journal of Medicine, 340(17), 1330-1340. https://frankino.uh.edu/assets/docs/lifesciseries/asmussen/sawyers.pdf
- Ren, R. (2005). Mechanisms of BCR–ABL in the pathogenesis of chronic myelogenous leukaemia. Nature Reviews Cancer, 5(3), 172-183. https://skeenapublishers.com/journal/ijor/IJOR-06-00037.pdf
- Lindauer, M., & Hochhaus, A. (2014). Dasatinib. Small Molecules in Oncology, 27-65. https://pubmed.ncbi.nlm.nih.gov/24756784/
- Lakka, N. S., Kuppan, C., Srinivas, K. S., & Yarra, R. (2020). Separation and characterization of new forced degradation products of Dasatinib in tablet dosage formulation using LC–MS and stability-indicating HPLC methods. Chromatographia, 83(8), 947-962. https://www.researchgate.net/publication/342196118_Separation_and_Characterization_of_New_Forced_Degradation_Products_of_Dasatinib_in_Tablet_Dosage_Formulation_Using_LC-MS_and_Stability-Indicating_HPLC_Methods
