NEW LEUKEMIA DRUGS
Five years ago, the drug gleevec changed the lives of patients with leukemia. But some patients become resistant to gleevec over time. Now, doctors are studying two new treatments that are even more potent.
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This is more than a visit to a botanical garden for Amy Baker. It's part of what she calls her "leukemic" adventure.
Amy was diagnosed with chronic myelogenous leukemia or CML. She first took the drug Gleevec.
Kapil Bhalla, MD
Hematologist/Oncologist
Moffitt Cancer Center and Research Institute
Tampa, FL
"It's a pill you take once a day and actually produces complete remission of this disease."
But Amy became resistant to Gleevec. Her only option -- a clinical trial in Florida. Amy lives in Ohio, so every 28 days, she hops a plane.
Amy Baker
Has CML
"I made up my mind when I was going to do this I would call this my leukemic adventure."
Doctor Kapil Bhalla is studying two drugs that are more potent than gleevec. They are AMN107 and dasatinib.
Kapil Bhalla, MD
"They are making a big difference in the progression of the disease in patients who have developed resistance to Gleevec."
With this type of leukemia, parts of chromosomes nine and 22 switch places, creating abnormaility called the Philadelphia chromosome.
Kapil Bhalla, MD
"We have a target in this disease."
Amy Baker
"You don't lose your hair. You don't get really, really sick."
And it's working. Before the treatment, Amy's Philadelphia chromosome level was at 90 percent and now it's down to 2.5 percent -- a big improvement.
Today, she's happily enjoying life and looking forward to fulfilling many other adventures.
Some patients with CML who can get to remission are then able to get a bone marrow transplant, which can be a cure for this disease. Doctor Bhalla says these new drugs have made this option available to more and more patients with CML who have a bone marrow match.
BACKGROUND: About 4,600 adults in the United States will be diagnosed with chronic myelogenous leukemia (CML) this year. Patients with CML have an overgrowth of white blood cells in their bone marrow and peripheral blood, which crowd out the red blood cells and platelets. Symptoms of the disease include fatigue, unexplained weight loss, fever, night sweats or pain on their left side under the ribs caused by the swelling of the spleen. CML is easy to diagnose because most cases are characterized by a genetic mutation called the Philadelphia chromosome. This chromosome is created when the long arms of chromosomes nine and 22 break off and switch places. The Philadelphia chromosome produces bcr-abl protein, which is an enzyme that tells the white cells to continue to grow even when too many already exist.
GLEEVEC: The drug Gleevec (imatinib) was so successful in 2001 that it quickly became the standard treatment for patients with CML. There was such a dramatic response with many patients achieving remission on Gleevec. However, Gleevec is not a perfect drug. Unfortunately, as with many other cancer therapies, some patients develop a resistance to it, and they require new treatment approaches.
NEW APPROACHES: Some of the new compounds being researched include AMN107 and dasatinib. Kapil Bhalla, M.D., from Moffitt Cancer Center and Research Institute in Tampa, Fla., says AMN107 is about 20-times more potent than Gleevec, and dasatinib is about 200-times more potent. At the American Society of Hematology 47th annual meeting in Dec. 2005, researchers reported these two new agents appear to be working well in patients with CML who have failed on Gleevec. Researchers say the best results were seen in patients in the chronic phase of the disease. However, they also say in the accelerated and blast phases of the disease, between 60 percent and 70 percent of patients responded to one of the drugs. They add that about half of the patients who become resistant to Gleevec have mutations, but in the AMN107 and dasatinib studies, patients respond whether they had mutations or not. Doctors say this finding is very encouraging.
WHAT IS NEXT? Doctors say once they have more follow up on the outcomes of patients on these drugs, they will start to use them in newly diagnosed patients with CML. They say another option for some patients is a bone marrow transplant. In order to get a bone marrow transplant, the patient first must be in remission. These newer agents could help patients achieve a remission in order to have the transplant. Dr. Bhalla says these drugs have made a curable treatment option available if they have a matched bone marrow transplant donor. Furthermore, doctors say they can paint a very optimistic picture for patients now diagnosed with CML. They feel these new agents are taking it from a controllable disease with long-term survival and moving it into a possibility for a potential cure -- even a cure at a molecular level.
Linda Loudon
Moffitt Cancer Center
Cancer Answers, FOW/LCS
12902 Magnolia Dr.
Tampa, FL 33612
(800) 456-7121
Copyright © 2006 Ivanhoe Broadcast News, Inc.
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