Well maybe it isn't as easy as "take your pick" but pretty close.
This process will depend on your Doctor and their practice and experiences.
When I was diagnosed my hematologist went over the top three TKI's that are usually prescribed first. Gave us some feedback and her opinion on all three meds. She then gave me the option on which one I wanted to try.
Any other health related issues need to be taken into consideration as there are a few well know side effects from these meds.
Now this may not be everyone's experience. I've heard from many others with CML that they were just given a prescription and most have started with Gleevec which is the standard first line drug.
Below is a list of the targeted therapy medications used to treat CML.
The following targeted therapy drugs are used to treat CML.
Imatinib (Gleevec) is the standard
first-line therapy for CML. It is usually taken once each day as a pill by
mouth. The dose may be increased in the accelerated and blast phases if the CML
relapses or if treatment doesn’t improve blood cell counts. Treatment with
imatinib can continue for a long period of time if it controls the disease.
Dasatinib (Sprycel) may be given as
the first-line therapy for CML. It may also be offered if someone cannot cope
with the side effects of imatinib or if the CML does not respond to, or stops
responding to, imatinib. Dasatinib is usually taken once each day as a pill by
mouth.
Nilotinib (Tasigna) may be given as
the first-line therapy for CML. It is given as a capsule that is taken by mouth
twice each day. Nilotinib may also be offered if someone cannot cope with the
side effects of imatinib or if the CML does not respond to, or stops responding
to, imatinib.
Bosutinib (Bosulif) may be given if
someone cannot cope with the side effects of, or the CML is resistant to
treatment with, imatinib, dasatinib or nilotinib. Bosutinib is usually taken
once each day as a pill by mouth.
Pontatinib (Iclusig) may be given if the
CML is resistant to other targeted therapies or if the leukemia cells have the
T3151 gene mutation. Pontatinib is usually taken once each day as a pill by
mouth.
Asciminib (Scemblix) is a TKI
targeting a very specific area of the BCR-ABL protein. This drug is used to
treat patients with chronic phase CML if two or more other TKIs have already
been tried or if their leukemia cells have a gene change called the T315I
mutation. Asciminib is another TKI to work against CML cells that have
the T315I mutation.