Hello All,

Here's the latest news on Sprycel from ASCO - it all sounds rather
good. It is nice to know that we have two options for this disease and
that evidence continues to grow in the overall efficacy of both
Gleevec and Sprycel. I heard a rumor that Tasigna (AMN 107) might be
approved this summer in the US. This will give us three options -
cheers for us!

As for the comments on the five year data with Gleevec, this being
cancer, I do not think we can wait another two years to play catch up.
The data for Gleevec will always be growing and it was the first drug
on the market - so that is a no brainer. Besides if we made that the
criteria for all drugs, then Gleevec would never have been so
successful. At the time Gleevec was launched there was 10 year data on
Interferon....The point being is that we have to be pioneers and take
certain calculated risks. This new evidence on Sprycel makes it a bit
eaiser for those struggling with having to make decisions on switching
treatment.

On the other comment raised at the end, I feel strongly that Dasatinib
will produce the same results as Imatinib - meaning that these
treatments cannot be stopped as neither Gleevec or Sprycel inhibit the
stem cells. But I feel confident that there has been much work in the
area of stem cells - so we'll just have to stay tuned.

Cheers to all!
Cheryl-Anne



ASCO: Dasatinib (Sprycel) Works as First-Line Therapy for Chronic
Myelogenous Leukemia


By Peggy Peck, Managing Editor, MedPage Today
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of
Medicine, University of California, San Francisco
June 02, 2007
add your knowledge Add Your Knowledge(tm) Additional ASCO Coverage

Ehab Atallah, M.D.
Anderson Cancer Center

CHICAGO, June 2 -- Almost all patients treated off-label with
dasatinib (Sprycel) for chronic myelogenous leukemia (CML) had a
complete cytogenetic response within a year of beginning therapy,
researchers reported here.

"Patients taking dasatinib achieve complete cytogenetic response -
absence of the mutated protein that drives this disease - more rapidly
than we've observed historically using the current front-line therapy.
Side effects are very manageable," said Ehab L. Atallah, M.D., a
fellow in oncology at the University of Texas M. D. Anderson Cancer
Center, in Houston.

He noted that dasatinib, which is approved for treatment of patients
who are unresponsive or resistant to treatment with imatinib
(Gleevec), was able to achieve a response in 40% of those difficult to
treat patients.

"Our hypothesis was that treating with dasatinib first would produce
an earlier response, which might translate to a better overall
survival," Dr. Atallah said at the American Society of Clinical
Oncology meeting. "We haven't proved that here, but these early
results are encouraging."

In the study, Dr. Atallah and colleagues treated 35 patients with CML
with dasatinib as a first-line therapy. Patients, who were enrolled
from November 2005 through December 2006, received either 100 mg of
dasatinib once a day or 50 mg twice daily.

Dose escalation to 140 mg/day or 180 mg/day or dose reduction to 80 to
40 mg a day, based on response and toxicity, was permitted.

In 77% of those patients a complete response was achieved as early as
three months; 92% of patients had a complete response at 6 months, and
95% had achieved a complete response at 12 months.

Those rates are slightly better than the six-month 54% complete
response for low-dose imatinib treatment (400 mg) observed at M. D.
Anderson, Dr. Atallah said. At 800 mg daily, imatinib had an 85%
response at six months and a 92% complete cytogenetic response at 12
months. The 12-month response for the 400 mg imatinib dose was 72%.

Dasatinib was approved by the FDA a year ago for use in patients whose
disease is unresponsive to or becomes resistant to imatinib.

Both drugs bind to and block a genetically flawed protein known as BCR-
ABL, which causes the disease. Dr. Atallah noted that dasatinib binds
to both open and closed forms of BCR-ABL, while imatinib binds only to
the closed form.

Dasatinib's side effects were manageable and mainly low-grade, with 15
patients having to temporarily stop treatment.

"This study is certainly good news for patients with chronic
myelogenous leukemia," commented Mitchell Smith, M.D., Ph.D., director
of the lymphoma service at Fox Chase Cancer Center in Philadelphia.

"It's always great for patients to have choices and now we have at
least two drugs that appear to work very well in this disease," he
said, "and there are even other drugs behind dasatinib that are going
to be available in case the front-line drugs don't work or are not
tolerated."

But Dr. Smith said it was unlikely that doctors would jump on
dasatinib as a first-line drug. "We have a lot of experience with
imatinib and we will want to see if dasatinib is effective for as long
as imatinib. We have evidence that imatinib is effective at least for
five years."

Moreover, even with evidence of dasatinib's efficacy, the durability
of the treatment effect is unknown. "We still don't know when-or if-it
will be possible to stop treatment," said Dr. Smith. "With imatinib,
we know that even after a year of treatment, the disease will return
if therapy is ended."

The trial was sponsored by Bristol-Myers Squib Co. Dr. Smith reported
no financial conflicts of interest.
Complete ASCO Coverage
Primary source: Journal of Clinical Oncology
Source reference:
Ehab Atallah, "Abstract 7005: Use of dasatinib in patients with
previously chronic myelogenous leukemia in chronic phase." Journal of
Clinical Oncology, 25:18S, p 358s.


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