Has anyone successfully stopped taking dasatinib?

Dasatinib (Dasatinib) is a targeted drug mainly used to treat Philadelphia chromosome-positive (Ph) chronic myelogenous leukemia (CML) and certain types of acute lymphoblastic leukemia (ALL). Dasatinib is a potent dual Abl/Src inhibitor with unsustainable tyrosine kinase inhibition at once-daily doses and a relatively short half-life of 3-5 hours. However, transient inhibition of K562 leukemia cells by high-dose pulse dasatinib or low-dose long-term treatment has been reported to irreversibly induce apoptosis.

Dasatinib eradicatesBcr/Abl ALL cells, causing significant apoptosis and eliminating tyrosine phosphorylation on Bcr/Abl, Src, Crkl and Stat-5. However, prolonged treatment of mouse ALL cells with lower doses of dasatinib allowed the emergence of viable drug-resistant cells. In clinical practice, some patients have achieved good responses and even achieved complete remission after using dasatinib, and discontinuation of the drug can eventually be considered. However, to successfully discontinue medication and maintain disease-free survival, certain conditions and specifications need to be met.

Patients usually need to continue treatment for a period of time before meeting the criteria for discontinuation. According to existing research, achieving complete cytological response (CCyR) or molecular response (MR4 or MR4.5) is the basic condition for drug discontinuation. This means that the patient's bone marrow examination and molecular testing results show no significant disease activity. During this stage, doctors will closely monitor changes in the patient's condition to ensure that the disease has not returned.

A patient's decision to discontinue a drug often relies on long-term evaluation of its efficacy. If dasatinib is well tolerated by the patient during treatment, without important adverse reactions, and if molecular monitoring results are stable, physicians may consider discontinuing the drug. Normally, regular monitoring is required after discontinuation of medication to detect signs of recurrence in a timely manner.