Imatinib for ALL (blood cancer)

Imatinib is a drug used to treat certain types of cancer mainly indicated in chronic myelogenous leukemia (CML), gastrointestinal stromal tumors (GISTs).

Imatinib acts by specifically inhibiting a certain enzyme that is characteristic of a particular cancer cell, rather than non-specifically inhibiting and killing all rapidly dividing cells, and served as a model for other targeted therapy modalities through tyrosine kinase inhibition. 

A study done in the University College London shows  promising results for a regimen of Imatinib (Gleevec) in patients with Philadelphia chromosome-positive (Ph+) ALL, a form of acute lymphoblastic leukemia that progresses rapidly and has a poor prognosis.

The team, led by Adele K. Fielding from University College London, tracked treatment outcomes of about 440 patients. The first group of Ph+ patients was treated solely with chemotherapy and stem cell transplants before imatinib became available in 2003. Post-2003, a second group was given 600 milligrams daily of imatinib following two rounds of chemotherapy. And in 2005, a third group received an earlier round of imatinib in conjunction with a second round of chemotherapy. The imatinib patients continued their drug regimen for two years.

After three years of follow-up, Fielding and colleagues found that each successive approach yielded better results. In the pre-imatinib group, the survival rate was 25 percent. By contrast, survival increased to 34 percent among the imatinib post-chemotherapy group and to 48 percent among the with-chemotherapy group.

The authors concluded that early treatment with imatinib can optimize long-term survival.