Cancer Treatment

Gleevec, the cancer therapy approved by the FDA in record time last month, is seeing its first stiff competition from a familiar foe...advanced-stage cancer.

The drug showed remarkable clinical trial results in the treatment of certain tumors, and its precise targeting of cancer cells raised hopes among experts that cancer would soon be managed like a chronic disease, treatable with regular drug therapy.

But a recent study reports that more than half of late-stage chronic myeloid leukemia (CML) patients who initially benefited from Gleevec treatments have since suffered relapses.

These findings do not come as a surprise to the drug's developers, however. Scientists first reported signs of resistance in late-stage CML patients last year, but these reports were lost in the general excitement about Gleevec's effectiveness in treating less advanced stages of CML.

Researchers believe that more effective treatment for advanced-stage CML lies in combination therapy. "Typically, advanced leukemias learn to become resistant to drugs in general," says Charles Sawyer of UCLA, one of the key researchers in this area. "One of the strategies in oncology for the past several decades has been to use combination treatment in order to prevent the leukemia from outsmarting you too early in the game."

Though these study results remind us that cancer is a formidable opponent, other recent study results indicate that Gleevec is a worthy match.

Recent results of another new CML study suggest that Gleevec increases in effectiveness the longer it is taken. Researchers found that response rates increased over time in all three phases of the disease, reinforcing researchers' belief that it is best to start drug treatment as early as possible.

"The earlier a patient is in the stage of their disease, the better chance that STI-571 (Gleevec) by itself can keep them in remission," says Sawyer.

Sawyer believes that researchers have much to learn about the potential benefits of this new drug. "The important studies are the ones that come subsequent [to the initial clinical trials] when you really learn how to use the drug, either alone or in combination. This is clearly just the beginning."

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