With
today's new advancements in prevention, detection and treatment, a
diagnosis of cancer no longer necessarily means facing a terminal
disease.
Cancer has always been synonymous with loss and fear. With today's new
advancements in prevention, detection and treatment, a diagnosis of
cancer no longer necessarily means facing a terminal disease. Rather,
as new advances provide more treatment options, cancer increasingly
takes on the shape of a chronic condition.
Recently, the National Cancer Institute (NCI) announced that leading
cancer organizations report that Americans' risk of dying from cancer
continues to decline, indicating that progress in prevention, early
detection, and newer treatments appear to be helping in the fight
against this disease.
The next revolution in cancer therapy will likely find its roots in the
ongoing Cancer Genome Atlas (TCGA), a pilot project initiated by the
National Cancer Institute (NCI) and the National Human Genome Research
Institute (NHGRI). Scientists have begun to discover that numerous
genes play a role in cancer, but they have only uncovered a small
portion of these genes. The Cancer Genome Atlas is aimed at helping to
accelerate the understanding of the genetic make-up of cancer.
Researchers hope that a better understanding of how cancer develops and
spreads, will lead to new tests to detect cancer in its early, most
treatable stages; new therapies to target cancer; and, ultimately, new
strategies to prevent cancer.
Understanding of the genetic basis for cancer has already allowed
researchers to develop the first drugs that target faulty genes, which
are making a difference in the lives of patients. Just ask Bob Ferber.
In July of 1999, the Los Angeles attorney was diagnosed with
Philadelphia chromosome-positive (Ph+) chronic myeloid leukemia (CML),
a malignant cancer of the bone marrow and blood.
Ferber tried many futile attempts at treatment before entering a
clinical trial for a drug now called Gleevec (imatinib mesylate)
tablets to help fight his disease. Gleevec, approved by the FDA in
2001, is one of the first "targeted therapies" and works by turning off
the specific cause of Ph+ CML, something The Cancer Genome Atlas hopes
to make possible for many more cancers. Within months, Ferber's white
blood cell counts were within normal range and his disease was in
remission.
"My CML diagnosis was a real scare. But, I'm grateful now. I'm grateful for every new day I have."
Sadly, not everyone's story is as positive as Ferber's. Hopefully, with
the continued advancement of cancer awareness and research,
preventative treatment and The Cancer Genome Atlas, cancer patients
will one day be able to breathe a sigh of relief and agree with Ferber
when he says, "Every time I challenge this cancer, emotionally or
physically-and survive-that's a victory for me."
Researchers have developed the first cancer-fighting drugs that target faulty genes.
Note to Editors: About Gleevec Tablets: Gleevec (imatinib mesylate)
tablets are indicated for the treatment of newly diagnosed adult
patients with Philadelphia chromosome−positive (Ph+) chronic myeloid
leukemia (CML) in chronic phase. Follow-up is limited. Gleevec tablets
are also indicated for the treatment of patients with Ph+ CML in blast
crisis, in accelerated phase or in chronic phase after failure of
interferon-alpha (IFN-a) therapy.
Important Safety Information1: Severe (NCI Grades 3/4) neutropenia
(3%−48%), anemia (<1%−42%), thrombocytopenia (<1%−33%),
hemorrhage (1%−19%), fluid retention (<1%−8%) (eg, pleural effusion,
pulmonary edema, and ascites) and superficial edema (1%−6%),
musculoskeletal pain (1%−9%), and hepatotoxicity (3%−8%) were reported
among Gleevec® recipients. Patients should be weighed and monitored
regularly for signs and symptoms of edema, which can be serious or
life-threatening. There have also been reports, including fatalities,
of cardiac tamponade, cerebral edema, increased intracranial pressure,
papilledema, and gastrointestinal perforation. Bullous dermatologic
reactions (eg, erythema multiforme and Stevens-Johnson syndrome) have
also been reported. In some cases, the reaction recurred upon
rechallenge. Several foreign postmarketing cases note a resolution or
improvement of bullous reaction following dose reduction with or
without supportive care. Dose adjustments may be necessary due to
hepatotoxicity, other nonhematologic adverse events, or hematologic
adverse events. Therapy with Gleevec was discontinued for adverse
events in 3% to 5% of patients. Patients with severe hepatic impairment
should be treated at a starting dose of 300mg/day and should be closely
monitored. Gleevec is metabolized by the CYP3A4 isoenzyme and is an
inhibitor of CYP3A4, CYP2D6, and CYP2C9. Dosage of Gleevec Tablets
should increase by at least 50% and clinical response should be
carefully monitored in patients receiving Gleevec Tablets with a potent
CYP3A4 inducer such as rifampin or phenytoin. Examples of commonly used
drugs that may significantly interact with Gleevec include
acetaminophen, warfarin, erythromycin, and phenytoin. Please see
enclosed full prescribing information for other potential drug
interactions. For daily dosing of 800mg and above, dosing should be
accomplished using the 400mg tablets to reduce exposure to iron. Use of
Gleevec Tablets is contraindicated in patients with hypersensitivity to
imatinib or to any other component of Gleevec Tablets. Women of
childbearing potential should be advised to avoid becoming pregnant
while taking Gleevec Tablets. Because of the potential for serious
adverse reactions in nursing infants, women should be advised to avoid
breast-feeding while taking Gleevec Tablets.
Common Side Effects of Gleevec Tablets1: The majority of the
approximately 1700 adult patients who received Gleevec in clinical
studies experienced adverse events at some time, but most were mild to
moderate in severity. The most frequently reported adverse events were
superficial edema (58%−81%), nausea (47%−74%), diarrhea (39%−70%),
muscle cramps (28%−62%), vomiting (21%−58%), rash (36%−53%), fatigue
(30%−53%), musculoskeletal pain (30%−49%), and abdominal pain
(30%−40%).* Supportive care may help management of most
mild-to-moderate adverse events so that prescribed dose can be
maintained whenever possible. Gleevec tablets should be taken with food
and a large glass of water to minimize gastrointestinal (GI)
irritation. Gleevec tablets should not be taken with grapefruit juice.
1 Gleevec® (imatinib mesylate) tablets prescribing information. East Hanover, NJ: Novartis Pharmaceuticals Corporation; 2005.
* Numbers indicate the range of percentages in 4 studies among adult
patients with Ph+ CML in blast crisis, accelerated phase, and chronic
phase.
