Cancer Therapies Right On Target

Cancer Therapies Right On Target

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; 2018.

* Numbers indicate the​ range of​ percentages in​ 4 studies among adult patients with Ph+ CML in​ blast crisis, accelerated phase, and​ chronic phase.

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