Total Symptom Score and Dose Adjustments: Fine-Tuning TKI Therapy in Systemic Mastocytosis

In "Total Symptom Score and Dose Adjustments: Fine-Tuning TKI Therapy in Systemic Mastocytosis," the expert pharmacists examined the following critical questions:

The Total Symptom Score (TSS) is a validated patient-reported outcome tool central to measuring treatment benefit in indolent systemic mastocytosis. How do pharmacists integrate TSS tracking into their clinical workflow?

Dose reductions may be required with tyrosine kinase inhibitors due to adverse events.a. When are dose reductions warranted with tyrosine kinase inhibitors?b. What are best practices for working with patients and physicians when reducing doses?

Led by the moderator, the panelists discussed how pharmacists integrate the Total Symptom Score into clinical workflows to track symptom burden over time and distinguish drug-related adverse effects, such as fatigue and cognitive changes, from disease-related symptoms. They also outlined best practices for dose reductions and treatment holidays with tyrosine kinase inhibitors, emphasizing careful titration to balance tolerability and disease control while reassuring patients that dose adjustments do not signal treatment failure.

Throughout the conversation, the experts provided a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

Our next episode, "Overcoming Barriers to Care in Systemic Mastocytosis: Access, Equity, and What's Next," further explores systemic mastocytosis, highlighting specialty pharmacy and insurance access barriers, strategies like copay assistance programs, and remaining unmet needs shaping the future of care.