When Gleevec Fails, Zarnestra May Help
Filed Under (Drug News) by David on 07-02-2010
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Although imatinib mesylate (Gleevec, Novartis) has been a boon to many patients with chronic myelogenous leukemia, it does not always succeed in prolonging life. But now patients with imatinib resistance may have another reason for hope: tipifarnib (Zarnestra, Johnson & Johnson).
In a phase 1 study at MD Anderson Cancer Center in Houston, Texas, 26 patients who did not respond to imatinib were treated with imatinib plus tipifarnib for three to 150 weeks. The combination demonstrated significant clinical activity: 17 of 25 evaluable patients (68%) showed complete hematological responses. Nine patients (36%) achieved cytogenetic responses. The median duration of response was three months (range, 2 to 30+ months).
An “interesting observation,” the researchers add, was the partial cytogenetic response in one patient with a T3151 mutation that was completely insensitive to imatinib, nilotinib (Tasigna, Novartis), and dasatinib (Sprycel, Bristol-Myers Squibb).
Although five patients stopped the treatment because of adverse events, the most frequent adverse effects were generally mild and manageable. Grade 3-4 neutropenia developed in 11 patients, and grade 3-4 thrombocytopenia occurred in eight patients. However, no patient died as a result of treatment-related myelosuppression, and only 15% patients were hospitalized.
(Source: Cancer 2007;2000-2006.)