About Glivec
The treatment of advanced and metastatic GIST has been revolutionised by Glivec (imatinib) since the year 2000. Because GIST is usually painless until quite large and is rarely suspected, many patients have advanced and/or metastatic disease when diagnosed. The only cure is surgery but for about many patients a cure is impossible.
The research which identified the imatinib compound took place in the late 1980s and early 1990s led by Dr Brian Drucker, a medical scientific researcher at Oregon Health Sciences University in the USA. Novartis, a Swiss based pharmaceutical company, was a major contributor to the research and development and now markets the drug.
Glivec is a tyrosine kinase inhibitor. Its action is very specific to particular molecules which activate the growth of certain cancer cells. It was developed to treat chronic myeloid leukaemia and trials started in 1998. Almost all patients responded, so outstanding a result that Glivec is now licensed in most countries for treatment of CML in all its stages. Many CML patients gain long term remission using Glivec, one of the greatest success stories of cancer research.
The first GIST patient to take Glivec did so in early 2000. Clinical trials quickly followed in Europe and the USA and results were so astonishing that steps were taken by doctors, supported by Novartis, to ensure that all eligible patients could receive the drug under clinical trial or compassionate conditions even before licenses were awarded. Glivec moved to a full marketing licence for GIST in the USA, Europe and many other countries faster than any other new treatment before it.
In the six years since treatment for GIST started a number of facts have become clear. About 85% of GIST patients with active disease respond to Glivec. The other 15% have a mutation of the c-kit which inhibits response. Survival with advanced GIST at two years is about 72% - before Glivec any survival for that length of time was rare. Patients in the very first trial of the drug have been closely followed and after five years half of them were alive, a few still in complete remission.
More information on treating advanced GIST
If you want to find out more the following links offer a starting point.
The NHS Guidelines for treating GIST with Glivec (imatinib)
Cancerbackup's pages (including useful info on side effects)
GIST Support UK - patient advice
The Liferaft Group - patient support and patient led GIST research
GIST Support International - patient support group
Reports on Dr Brian Drucker's early research