Has resistance to Glivec been observed?
• As experience accumulates with Glivec in CML, it is apparent that some patients in chronic phase and a substantial proportion of patients in the advanced disease phases are either initially refractory to Glivec therapy (primary or intrinsic resistance) or develop resistance with time (secondary resistance or relapse) after an initial response. • The most important approach to avoiding resistance is to administer full therapeutic doses of Glivec as early as possible49. Starting with at least the approved Glivec dosage, 400 mg/d for chronic-phase and 600 mg/d for advanced-phase CML, can aid in diminishing relapse risk50. Dose escalation has been investigated as a means of avoiding resistance49, 79.
