Agree with Tim. The driving force here for me is the potential long terms risks of ongoing nilotinib given the risks. Two options. If discontinuing drug is paramount, I would do it step wise as Destiny would suggest and monitor. I definitely would decrease the nilotinib to 300bid immediately for starts. If continuing a drug is the approach, then a switch would be in order. Dasatinib yes, but this person would not need 100. Would likely be maintained on 50 a day of dasatinib. Bosutinib at 300 a day is also an option. Although I am sure many would not agree, the patient seemed to tolerated imatinib very well and given the response that they now have, going back to imatinib could be considered. This is something that I have now done on several occasions, with the argument that the mutated clone is now gone. Close monitoring is very important.