NY Times Op-Ed pages

[Guest guest]

Don't know if this was already mentioned: Last Sunday's

edition of the NY Times had 2 pages of cancer-related

articles. Date is April 1, 2007, pages 12 & 13.

All the articles are of interest. The one titled " The

Smart-Pill Solution " devotes a paragraph to Gleevec: " the

first smart anti-cancer pill. "

Since I need a tutorial in how to send links you're on your

own...

Best regards,

Ruth

[Guest guest]

Hi Ruth,

Here is the url followed by the text.

Zavie

http://www.nytimes.com/2007/04/01/opinion/01nathan.html?th & emc=th

Op-Ed Contributor

The Smart-Pill Solution

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By DAVID G. NATHAN

Published: April 1, 2007

Boston

OUR sympathy for and Tony Snow is understandably shadowed

by worry and frustration. Will they be saved, and will our own loved ones be

saved as well? Since 1971, when President Nixon declared war on cancer, the

budget of the National Cancer Institute has increased to $4.8 billion from

half a billion, and private donations have likewise increased. Why don't we

have more to show for this generous effort?

The simplest answer is that it has taken us this long to begin to decipher

the genetic mutations involved in cancer. Until we could see how changes in

DNA actually drive the disease, we could do nothing to interfere with it

beyond surgery, radiation therapy and standard chemotherapy. But in recent

years we have created and begun to apply so-called targeted-therapy drugs.

And though progress is slow, it is fair to say that we have finally turned

an important corner.

For most of the past half-century, medical treatment of invasive tumors like

those of the breast and colon has relied mainly on drugs, radiation or both,

in effect carpet-bombing the DNA of cancer cells. This highly toxic

treatment is effective in many cases, but it does not address the root

causes of cancer.

Fortunately, the revolution in genetics of the past 30 years has taught us

how cancer results from defects in DNA repair that arise when certain genes

are damaged by solar radiation, tobacco smoke and the chemical products of

intestinal bacteria and cell metabolism. Cancer cell genes depend on only a

very small number of mutated genes to ensure their own survival. These are

typically the genes responsible for repairing other genes and for

controlling growth and death. Our challenge is to outsmart the cancer by

determining which genes are keeping the cancer going, and to design drugs

that can inhibit them.

The first such " smart " agent to see action in patients has been trastuzumab,

better known as Herceptin, which is not a drug in the strict sense but

rather a large protein, an antibody that binds to a growth-controlling

protein found in about 20 percent of patients with a highly aggressive form

of breast cancer. When it is administered with standard chemotherapy and

radiation, Herceptin ties up the protein, and thus markedly improves the

survival of such patients.

Gleevec (imatinib), the first smart anticancer pill, inhibits a protein

produced by a single gene that is key to the growth of a form of leukemia.

Even more remarkable has been Gleevec's effect on an intractable bowel

cancer known as gastrointestinal stromal tumor, a ravaging tumor derived

from nerve cells in the bowel wall. In its early stages, this cancer is

driven by a single gene and its protein, and it can be inhibited overnight

by a single dose of Gleevec. A substantial number of patients who have

received this drug have remained in remission for years.

There are now at least 100 such smart antibodies and drugs in practice,

clinical trials or development. Among them are Iressa (gefitinid) and

Tarceva (erlotinib), which are effective in treating about 10 percent of

lung cancers, those that are initiated by a specific mutation in a

growth-controlling gene. But we need many more, because cancer cells are

wily foes that readily develop further mutations to help them evade such

drugs. Also, because cancer cells are genetically unstable and vary slightly

from one to the next, it is difficult for a single drug attacking a single

protein to do the whole job. We need multiple smart drugs, and creating them

will take time.

Patients, organizations that finance research and the public want faster

progress. So do cancer researchers and clinicians. We are trying, and we are

succeeding. The pace is slow because the problem is difficult, but we will

get there.

G. , the president emeritus of the Dana Farber Cancer Institute,

is the author of " The Cancer Treatment Revolution. "

[ ] NY Times Op-Ed pages

Don't know if this was already mentioned: Last Sunday's

edition of the NY Times had 2 pages of cancer-related

articles. Date is April 1, 2007, pages 12 & 13.

All the articles are of interest. The one titled " The

Smart-Pill Solution " devotes a paragraph to Gleevec: " the

first smart anti-cancer pill. "

Since I need a tutorial in how to send links you're on your

own...

Best regards,

Ruth