Oncology Brothers: Practice-Changing Cancer Discussions Managing Toxicities of Tyrosine Kinase Inhibitors (TKI) in CML - Drs. Onyee Chan & Fadi Haddad
Nov 10, 2025
This discussion features Dr. Fadi Haddad, a hematologist-oncologist specializing in chronic myeloid leukemia (CML) and TKI management, alongside Dr. Onyee Chan, an expert in CML toxicities and patient counseling. They explore the various generations of tyrosine kinase inhibitors and their class-wide toxicities. Key topics include unique side effects of each TKI, strategies for dose optimization, and the critical role of patient education in managing complications effectively. They also delve into specific drug issues, including dasatinib monitoring and bosutinib's GI side effects.
AI Snips
Chapters
Transcript
Episode notes
Start With Clear Toxicity Counseling
- Discuss TKI-specific common toxicities with patients upfront so they know what to expect and when to report symptoms.
- Emphasize dose optimization and monitoring to keep patients on therapy while minimizing harms.
Manage Dasatinib Pleural Effusions Proactively
- For dasatinib watch for pleural effusion and educate patients to report new or worsening dyspnea or chest pain promptly.
- Manage effusions with diuretics, hold the drug for severe cases, then consider dose reduction on restart.
Titrate Bosutinib Gradually
- Start bosutinib at the lowest tolerated dose and up-titrate slowly while watching for diarrhea and transaminitis.
- Prefer dose reductions over switching drugs if efficacy is maintained and side effects emerge.