What is the best drug for CML in 2025 (and how to get it in Nigeria)?

Yearly, there are about 1600 new cases of chronic myeloid leukemia (CML) in Nigeria ¹. While there is no cure for the condition (yet), the last decades have seen a number of novel medicines emerge to manage CML.

If you're a Nigerian patient dealing with this condition, you're probably wondering what the latest treatments are, and whether you can get them locally. Here's a quick overview of CML drugs available in Nigeria.

Is there a best drug for CML?

The short answer is, no. However, there are multiple options for patients to try. Since the introduction of targeted therapies, such as tyrosine kinase inhibitors (TKI), they have become the standard of care around the world.

However, there are additional treatments in development, including combination therapies and immunotherapy. It may be possible that we're just a few years away before an even better CML treatment becomes available.

How is CML treated in Nigeria?

In Nigeria, CML is primarily treated with tyrosine kinase inhibitors (TKIs), such as  Gleevec (imatinib). Gleevex is widely accessible through the Glivec International Patient Assistance Program (GIPAP) supported by Novartis and The Max Foundation. This program has significantly improved survival rates for patients.

However, challenges persist, including limited access to second-generation TKIs. This is important, as imatinib resistance can occur. If it does, it may lead to disease progression and make CML harder to treat. 

If you're dealing with resistance to Gleevec, here are some alternatives to discuss with your doctor.

What are Gleevec alternatives?

By now, there are three generations of TKIs, each one being more advanced and precise than the ones before. Therefore, if you've started responding poorly to your current treatment with Gleevec, you have other options.

Here are some of the latest alternatives to imatinib.

• Sprycel (dasatinib)

  • Generation: Second-generation TKI;

  • Sprycel vs Gleevec: Sprycel is more potent than imatinib and can be effective in patients with imatinib resistance;

  • Limitations: Not effective against the T315l mutation;
  • Availability in Nigeria: Not available or scarce.

• Tasigna (nilotinib)

  • Generation: Second-generation TKI;
  • Tasigna vs Gleevec: Tasigna is more potent than Gleevec and highly selective in targeting the BCR-ABL protein. It can be used in patients who are resistant or intolerant to imatinib;
  • Limitations: Requires fasting for proper absorption, and isn't effective against the T315l mutation.
  • Availability in Nigeria: Tasigna (nilotinib) is not readily available in NIgeria. However, if you have a prescription from your doctor, you can get the medicine right away. Simply request it via the button below.

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• Bosulif (bosutinib)

  • Generation: Second-generation TKI;
  • Bosulif vs Gleevec: Bosulif is more potent than Gleevec and targets a broader range of mutations. It can be used in patients who are resistant multiple other TKIs;
  • Limitations: Not effective against the T315l mutation.
  • Availability in Nigeria: Bosulif (bosutinib) is not widely available in NIgeria. However, if you have a prescription from your doctor, you can get the medicine right away. Click below to get started.
    
    

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• Iclusig (ponatinib)

  • Generation: Third-generation TKI;
  • Iclusig vs Gleevec: Unlike Gleevec and other first- and second-generation TKIs, Iclusig is effective against the T315l mutation. It's designed for patients with the mutation, who are resistant to multiple TKIs;
  • Limitations: The medicine may be associated with cardiovascular adverse effects;
  • Availability in Nigeria: Iclusig (ponatinib) is unfortunately not widely available in Nigeria as of January 2025.

Other drugs for CML that can replace Gleevec

In addition to newer-generation TKIs, there is also a new class of TKIs - the so-called allosteric inhibitors. One example of an allosteric inhibitor is Scemblix (asciminib). Here's what you should know about it:

• Scemblix vs Gleevec: Scemblix has a different mechanism of action compared to other TKIs. It targets the myristoyl pocket of BCR-ABL. It's effective for patients resistant to other TKIs, as well as for those with the T315l mutation;
• Limitations: It's a newer drug for CML. Its first approval was in 2021, for treating Ph+ CML, followed by an approval in 2024 for use in newly diagnosed CML cases ².
• Availability in Nigeria: As a new CML medicine, Scemblix (asciminib) is not yet widely available in Nigeria. Has your treating doctor prescribed it? Then you don't have to wait. Share your prescription with our expert medicine access team via the button below, and we'll help you get the medicine right away.

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Always the best CML medicines

With Gleevec still dominating the CML treatment landscape in Nigeria, it can feel impossible to access alternative treatments. However, they exist and you can get them right away, with the help of Everyone.org. The only thing you need to get started is a prescription from your doctor.

Simply contact our expert team at Everyone.org. We'll help you get the best treatment for CML in Nigeria. Of course, always following your doctor's recommendation.

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Referanslar:

1. Chronic Myeloid Leukemia in Nigerian Patients: Anemia is an Independent Predictor of Overall Survival. Clinical Medicine Insights: Blood Disorders, Accessed 29 January 2025. 
2. Stewart, Judith. Scemblix (asciminib) FDA Approval History. Drugs.com, Accessed 29 January 2025.