Community Oncologist

Would you discontinue Nilotinib for CML after 3 years of treatment if patient achieved MR4 only for > 2years (not MR 4.5) with prior imitanib failure? No History of AP or BP.

Myeloproliferative Neoplasms Specialist

If the patient had true imatinib failure, then discontinuation is not recommended. If it was imatinib intolerance then you could attempt discontinuation with nilotinib as long as he has been on treatment for 3 years with MR4 for 2+ years. In that case, would monitor PCRs monthly and restart nilotinib if he loses MR. But again this is only really an option if he discontinued imatinib for intolerance rather than failure.