RE: A few thoughts - Sharon's question

[Guest guest]

Good question, Sharon!

Ok, please understand that this is a very quick, rudimentary and crude attempt

to shed some light on your question. Hopefully, it will help.

So with that said, here goes...

Yes, all three drugs are similar in their function and intent. One of the

differences is in the way the respective drug molecules bind to the receptor

point/atp binding site on BCR-ABL. Here's one way of thinking about it....get

the " square peg - round hole " idea in your mind. Now, think of Gleevec as that

round peg that fits into the round hole in bcr-abl. In a good number of people,

this works well and inhibits bcr-abl and effectively " turns it off " . In some

cases, bcr-abl, instead of having a " round hole " , might have one of another

shape. You might think of second line therapies as being more malleable and

able to conform and bind more securely or differently to that receptor point/atp

binding site ( " hole " ).

Here's a couple of links to videos on how Gleevec/Glivec binds:

http://www.youtube.com/watch?v=HXmj_UuYwQ8

http://www.youtube.com/watch?v=QR6d2cfImRc

(you will have to paste the links into your browser)

I will continue to search for images/animations of the mechanism of the other

drugs

I'm sure others will chime in and help here.

>

> >

> >

> > Hi all - When I went to the lab today I was asked if I was on the " magic

> > pill " that was on Dr. Oz last night? I was able to turn the question into

> an

> > opportunity to educate others. You see, at this point, Gleevec isn't

> working

> > for me, and what I need more than anything is straight information. I

> think

> > other patients deserve the same.

> >

> > Last night's program was a great example of branding Gleevec as a leading

> > drug in cancer care. As a public relations professional I have to

> > congratulate the Novartis team for a job well done on behalf of their

> > product, and appreciate the fact that Dr. Druker was credited and

> included.

> >

> > As a CML patient, however, I would have preferred a less dramatic and more

> > factual segment that I could have used to educate others. What I/we got is

> > an entertaining segment that can still be used to educate others by

> > addressing the key points that were left out and why they matter. There is

> a

> > lot of value in having " America's Doctor " talk about CML and we can seize

> > this opportunity for the good of others if we want. I know that's what I'm

> > doing.

> >

> > Take care everyone,

> > Pat in Phoenix

> >

> >

> >

>

>

>

[Guest guest]

Sharon - To answer what I think was one of your questions, the theme of the Dr.

Oz Show was the 10th anniversary of Gleevec, so that's why they kept the

discussion to just the one drug. I would also expect to see more such news

stories in the months again. From the branding standpoint of Novartis, that

message is in their best interest and it's also the most appealing in terms of

getting air time and ink for the product. Perhaps we CMLers should have some

kind of celebration ourselves, and also honor those we've lost.

> >

> > I have a question. Are Sprycel and Tasigna the same as Gleevec?

> > I have been on all three and I do not understand what one (gleevec) has that

> > the other two do not. Why are then not discussed as a miracle pill also?

> > Sharon

> >

>(snip)

[Guest guest]

Why does Gleevec get all the praise it what I am wondering? Is it because

it was the first?

Is Gleevec better then Tasigna. Tasigna works for me. I am PCRU with it so

why do we have to have so many of the same drugs that do the same thing?

And another thing Gleevec and Tasigna are both with Novartis aren't they?

What does Tasigna have that Gleevec does not have or what does Tasigna have

that Gleevec does not have. Is it as simple as two different antiobiotics

that do the same thing?

But what really confuses me is if the medications are the same and do the

same thing how come we all have different side effects from some and not the

others?

It is way to confusing to me. I had terrible side effects from Gleevec and

sprycel but none with Tasigna.

Thank you so so much for helping me understand this Greg

Sharon T

_____

From: [mailto: ] On Behalf Of

gregscmlhope

Sent: Wednesday, May 12, 2010 9:18 PM

Subject: Re: [ ] A few thoughts - Sharon's question

Good question, Sharon!

Ok, please understand that this is a very quick, rudimentary and crude

attempt to shed some light on your question. Hopefully, it will help.

So with that said, here goes...

Yes, all three drugs are similar in their function and intent. One of the

differences is in the way the respective drug molecules bind to the receptor

point/atp binding site on BCR-ABL. Here's one way of thinking about

it....get the " square peg - round hole " idea in your mind. Now, think of

Gleevec as that round peg that fits into the round hole in bcr-abl. In a

good number of people, this works well and inhibits bcr-abl and effectively

" turns it off " . In some cases, bcr-abl, instead of having a " round hole " ,

might have one of another shape. You might think of second line therapies as

being more malleable and able to conform and bind more securely or

differently to that receptor point/atp binding site ( " hole " ).

Here's a couple of links to videos on how Gleevec/Glivec binds:

http://www.youtube.com/watch?v=HXmj_UuYwQ8

http://www.youtube.com/watch?v=QR6d2cfImRc

(you will have to paste the links into your browser)

I will continue to search for images/animations of the mechanism of the

other drugs

I'm sure others will chime in and help here.

>

> >

> >

> > Hi all - When I went to the lab today I was asked if I was on the " magic

> > pill " that was on Dr. Oz last night? I was able to turn the question

into

> an

> > opportunity to educate others. You see, at this point, Gleevec isn't

> working

> > for me, and what I need more than anything is straight information. I

> think

> > other patients deserve the same.

> >

> > Last night's program was a great example of branding Gleevec as a

leading

> > drug in cancer care. As a public relations professional I have to

> > congratulate the Novartis team for a job well done on behalf of their

> > product, and appreciate the fact that Dr. Druker was credited and

> included.

> >

> > As a CML patient, however, I would have preferred a less dramatic and

more

> > factual segment that I could have used to educate others. What I/we got

is

> > an entertaining segment that can still be used to educate others by

> > addressing the key points that were left out and why they matter. There

is

> a

> > lot of value in having " America's Doctor " talk about CML and we can

seize

> > this opportunity for the good of others if we want. I know that's what

I'm

> > doing.

> >

> > Take care everyone,

> > Pat in Phoenix

> >

> >

> >

>

>

>

[Guest guest]

Oh yes I forgot it was the tenth anniversary of Gleevec.

And yes we should celebrate it and also honor those we lost.

9 years ago my mother was in the hospital with lymphoma and leukemia (she

had so many other things too) and I remember the doctors telling her that

there was a new medication that just came out and she may be able to try it.

She was too sick and they never gave it to her. I am remembering that I

think it was Gleevec that they were talking about.

Do you know what the other cancers are that it helps?

Sharon

_____

From: [mailto: ] On Behalf Of

phoenixpat

Sent: Wednesday, May 12, 2010 10:06 PM

Subject: Re: [ ] A few thoughts - Sharon's question

Sharon - To answer what I think was one of your questions, the theme of the

Dr. Oz Show was the 10th anniversary of Gleevec, so that's why they kept the

discussion to just the one drug. I would also expect to see more such news

stories in the months again. From the branding standpoint of Novartis, that

message is in their best interest and it's also the most appealing in terms

of getting air time and ink for the product. Perhaps we CMLers should have

some kind of celebration ourselves, and also honor those we've lost.

> >

> > I have a question. Are Sprycel and Tasigna the same as Gleevec?

> > I have been on all three and I do not understand what one (gleevec) has

that

> > the other two do not. Why are then not discussed as a miracle pill also?

> > Sharon

> >

>(snip)

[Guest guest]

>

> Why does Gleevec get all the praise it what I am wondering? Is it because

> it was the first?

>

> Is Gleevec better then Tasigna. Tasigna works for me. I am PCRU with it so

> why do we have to have so many of the same drugs that do the same thing?

>

> And another thing Gleevec and Tasigna are both with Novartis aren't they?

> What does Tasigna have that Gleevec does not have or what does Tasigna have

> that Gleevec does not have. Is it as simple as two different antiobiotics

> that do the same thing?

____________________________________________

Hi Sharon,

This program was about Gleevec because Gleevec was the first drug, and if

Gleevec had not been developed there would not have been a Tasigna, a Sprycel or

the other drugs now in the pipeline.

Dr. Druker spent 10 years in the lab doing research to develop Gleevec before

there was ever any human trials. With this drug, he proved/demonstrated that if

you could identify the defect that was causing the cancer (and this was already

known for CML, the ph+ cell), then you could develop a drug specifically for

that target. This is like a smart bomb vs just an atomic bomb (blow everything

up). Dr. Druker is expected to get a Nobel Prize in Medicine in the

future....not because he developed just a drug for CML but because he showed how

to develop a 'molecularly targeted drug'. This changed cancer research and

cancer treatment.....and I think this was a major point of the show. The show

was not really about CML, it was about a 'cancer breakthough'......that was a

title of the show.

All of the cml drugs are not the same. Early on they saw that some people either

had mutations or developed mutations and that Gleevec was not going to work for

them....which is why the drug companies went to work to develop more drugs (and

get a piece of the financial pie).

Gleevec only works during one phase of the cell cycle (can't remember if it is

the open phase or the closed phase).

Tasigna is 2nd generation Gleevec, the improved version that some people

need....it works in both the open and closed phases of the cell cycle. Both are

Novartis drugs. There is talk that Norvartis will try to replace Gleevec with

Tasigna as the front line (first used) drug for CML.

Sprycel, developed by BMS, has a sl. different way of working....Dr. Druker

tells me it is 'more broad spectrum' and so is more effective for some people.

It also affects a second pathway, which some thinks makes it more effective.

All anti-biotics are not the same....that is why you test an infection for

sensitivity to the drug. All CML drugs are not the same, but basically aim to do

the same thing...kill off the cml cell.

We all know from this list that some drugs are working better than others for

some people. If everyone had a great result to Gleevec, there would not have

been as much incentive to develop the other drugs (but they were really

developed because of the mutations), and it was found that some have fewer side

effects, but this varies with people.

All of this information is really out there...and has been. The development of

Gleevec is really a fascinating story and there is a book written about it by

the CEO of Novartis.

C.