Cancer Drug Might Fight Lethal Lung Hypertension

[Guest guest]

Cancer Drug Might Fight Lethal Lung Hypertension

By E.J. Mundell

HealthDay Reporter

WEDNESDAY, Sept. 28 (HealthDay News) -- Gleevec, a medication experts have

hailed as a wonder drug in the fight against certain cancers, may also come

to the rescue of patients battling lethal pulmonary hypertension.

According to a case study in the Sept. 29 issue of the New England Journal

of Medicine, a 61-year-old man suffering from an advanced case of the

disease saw his condition improve and stabilize after taking Gleevec

(imatinib) -- even though all other medications had failed.

" Only the addition of Gleevec was able to prevent further deterioration, and

even improved his condition, " said co-researcher Dr. Hossein A. Ghofrani, of

University Hospital Giessen, in Germany.

Although a single case report does not warrant widespread use of Gleevec for

pulmonary hypertension, the German researchers who wrote the report said

they are now planning a large clinical trial.

" I think a trial is a wonderful idea, " said Dr. Stein, a professor

of clinical cardiology at Albert Einstein Medical College in New York City,

and a spokesman for the American Heart Association. " Hopefully, we'll be

able to make a real difference for these people. "

According to Stein, pulmonary hypertension occurs when blood pressure mounts

to dangerously high levels in the pulmonary artery, which carries blood from

the right side of the heart to the lungs. The relatively common condition

can occur for many reasons, but most often arises as a byproduct of other

pathologies, such as heart disease and various lung ailments. Under the

strain of these conditions, the pulmonary artery thickens and stiffens,

causing blood pressure to rise.

" Right now, we have two classes of drugs that seem to be improving

outcomes, " Stein said. These include prostaglandin-linked compounds such as

prostacyclin, and, more recently, another potent vasodilator -- Viagra

(sildenafil). Both drugs work by relaxing and opening narrowed vessels.

" None of these medications cure the disease or give the patient a normal

life back, " Stein noted. " But most can prolong quality-of-life time before

they get very sick. " Patients with very high pulmonary blood pressures

usually don't live past a year, he said.

In the German case report, the patient was diagnosed with just such a case

of advanced pulmonary hypertension, this time a rarer, " primary " form of

unknown origin. Standard therapies such as prostacyclin and Viagra proved

useless, and the man's condition continued to deteriorate.

" In this desperate situation, we decided to initiate compassionate treatment

with daily administration of 200 milligrams of oral imatinib mesylate

(Gleevec), " given on top of the other medications, the researchers

explained.

The change in the man's condition was dramatic.

By three months, his condition had improved " impressively, " the researchers

said, allowing him to become much stronger and more mobile than before

Gleevec. That improvement has continued to the six-month point, they add.

The therapy appears to be working in other patients, too. " We have

[successfully] treated more than 20 patients so far, all of which had no

other therapeutic options or who were waiting on the transplant list for a

new organ but appeared to run out of time, " noted co-researcher Dr.

Friedrich Grimminger, also of Univerity Hospital Giessen.

How did a drug best known for curing chronic myelogenous leukemia beat back

hypertension?

Unlike the other drugs, Gleevec does not appear to work by dilating blood

vessels, according to the researchers. Instead, the key to its effect lies

in a phenomenon shared by both cancer and pulmonary hypertension.

" In cancer, tissue proliferation is uncontrolled and leads to the spreading

of the tumor, " Grimminger explained. " In pulmonary hypertension, also,

uncontrolled growth of the vascular wall is the underlying mechanism of the

disease. "

" Gleevec is a drug which suppresses uncontrolled growth of tissue by

specific blockade of the so-called tyrosine kinase pathway, " he added. " We

have proven that this pathway also plays an important role in the course of

pulmonary hypertension. Due to these similarities, the anticancer drug

Gleevec also works in progressive pulmonary hypertension. "

This mechanism made sense to Dr. Norman Edelman, chief medical officer at

the American Lung Association.

" What happens in response to hypertension is that vessels get thicker, " he

said. " The assumption is that [Gleevec] reverses that. So this treatment

does have biologic validity, it's plausible. "

In fact, because tissue proliferation is a hallmark of other serious

illness, Gleevec's uses might expand even further, according to researcher

Ghofrani. " Our current findings might open the door to a completely new

therapeutic field of targeted treatment for chronic proliferative diseases

such as atherosclerosis, COPD, lung emphysema or lung fibrosis, " he said.

Right now, the emphasis is on pulmonary hypertension, however. " A large

worldwide clinical trial is about to be conducted under our scientific

lead, " Ghofrani said. Besides testing Gleevec's safety and effectiveness,

" we also hope to answer the question [of] whether the drug also works in

earlier stages of the disease, " he noted.

Stein stressed that, right now, experts have " just one report of the drug

being effective. " But he's hopeful that the results seen in this patient

will be repeated in the upcoming trial. If that's the case, " Gleevec may

turn out to be a valuable third product that we can use for these people, "

he said.

[Guest guest]

> Cancer Drug Might Fight Lethal Lung Hypertension

> By E.J. Mundell

> HealthDay Reporter

>

> WEDNESDAY, Sept. 28 (HealthDay News) -- Gleevec, a medication

experts have

> hailed as a wonder drug in the fight against certain cancers, may

also come

> to the rescue of patients battling lethal pulmonary hypertension.

______________________________________

Wow!!