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Report on the Relative Efficacy of Oral Cancer Therapy for Medicare Beneficiaries Versus Currently Covered Therapy

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Figure 7: Predictors of CML Response with Imatinib

Timing of use of the predictors of imatinib response Currently widely available Available in some areas In development
At the start of therapy Cytogenetic analysis:
  • Cytogenetic clonal evolution.
  • % of Ph+ metaphases.
  • Chromosome 9 deletions.
Flow cytometry
  • % of CD34+ cells in the bone marrow.
  • Genetic microarrays.
  • Expression of drug resistance genes.
  • Laboratory analyses that provide information n mutations that change the tyrosine kinase protein.
  • In vitro assay of Crkl phosphorylation with imatinib.
During therapy Cytogenetic analysis:
  • Cytogenetic response at 6 or 12 months.
Flow cytometry
  • Reduction in the % of CD34+ cells in the bone marrow.
  • Log reduction in BCR-ABL mRNA transcripts at 1, 3, 6, or 12 months.
  • Log reduction BCR-ABL mRNA transcripts as a predictor mutations in the protein binding of imatinib.

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