BBC - Pill to treat leukaemia Glivec has produced very impressive results

A pill that can reduce the progress of a deadly form of cancer called chronic myeloid leukaemia (CML) is being launched in the UK.

Glivec, which works by precisely targeting the molecules thought to cause the cancer, has produced highly promising results in clinical trials on over 7,500 patients world-wide.

The drug normalised the blood count in over 90% of patients, and reduced leukaemia cells in the bone marrow.

Over 90% were free of the disease 12 months later, with more than 50% showing complete or near complete disappearance of an abnormal gene that triggers the development of the disease.

The drug also has none of the severe side effects associated with current chemotherapy drugs used to treat the condition.

This is because it only targets the cancer cells, and leaves healthy cells unaffected.

Doctors involved a trial of the drug in Scotland said the results were the most exciting and encouraging they had ever seen.

The 77 patients involved in the tests at Glasgow Royal Infirmay this year reported very few side-effects from Glivec.

It is thought the drug may also be effective in treating other forms of cancer.

Professor John Goldman, of Hammersmith Hospital, London, said: "Glivec has transformed the treatment of chronic myeloid leukaemia.

"Up to now all the usual therapy for leukaemia has basically involved blunderbuss therapy, in other words killing all cells and hoping that you kill more leukaemia cells than normal cells.

"The elegance of Glivec is that it goes precisely for leukaemia cells, almost entirely sparing the normal cells.

"This is the first example of a molecularly targeted therapy that really does work."

Patient

Sandy Craine, from London, is one of the patients who has been successfully treated with Glivec. She takes six pills a day just after dinner.

She was initially told by doctors that she would die within a year without a bone marrow transplant.

But her white cell count normalised very quickly after starting treatment with Glivec.

"I would say I am a very happy person now. I'm well, I'm normal, I'm like everybody else.

"I had a threat of death hanging over my head, I don't have that anymore. I feel better than I have for years."

Common form

Chronic myeloid leukaemia is one of the four most common types of leukaemia. It affects around 800 people in the UK each year.

The only potential for cure is a bone marrow transplant, a high-risk procedure for which only 20% of patients are eligible. The other option is chemotherapy.

CML can strike at any age, but mainly affects the 40-60 year age group.

It has three phases: the chronic, lasting up to four years; the accelerated, lasting up to nine months; and the final, often fatal blast crisis phase, lasting up to six months.

Developed by Novartis Oncology, Glivec is designed to target an abnormal piece of genetic material in the bone marrow cells - the Philadelphia Chromosome.

The Philadelphia Chromosome is created by an exchange of genetic material between two normal chromosomes, 9 and 22.

It contains a fused gene which produces a protein that triggers an accelerated production of white blood cells, and a decrease in cell deaths.

Glivec prevents this disruption by binding to a protein that plays a crucial part in the process.

The Department of Health has indicated that patients who have started to take Glivec as part of the clinical trials should be allowed to continue to receive the drug on the NHS.

A decision on its wider availability will be taken next year by the National Institute for Clinical Excellence.

-- Anonymous, November 27, 2001