Glivec(R) is the First Adjuvant Treatment Approved in the UK to Delay Return of Gastrointestinal Cancer After Surgery
Posted on: Friday, 8 May 2009, 00:00 CDT
FRIMLEY,
- Glivec(R) (imatinib) Now Approved in the UK for Post-Surgery Treatment of Patients With KIT (CD117)-Positive Gastrointestinal Stromal Tumours (GIST), who are at Significant Risk of the Cancer Returning After Surgery(1)
- Use of Glivec(R) After Surgery Significantly Reduces Risk of Cancer Relapse(2)
- If Untreated After Surgery, 50% of patients Will Experience Their Cancer Returning Within Two Years(3,4)
Glivec(R) has been approved in the UK for the treatment of patients with the gastrointestinal cancer, KIT (CD117)-positive gastrointestinal stromal tumours (GIST), who have had surgery to remove their cancer and are at significant risk of the cancer returning.(1) Data supporting this new use for Glivec demonstrates that 98% of patients receiving 400mg Glivec daily for a year after surgery to remove their GIST did not experience their tumours returning after 12 months compared to 83% of patients taking placebo.(2)
Approximately 900 people in the UK are diagnosed with GIST(5) each year and approximately 86% of those diagnosed will undergo surgery to remove the tumour or tumours.(6) However, if left untreated after surgery, almost 50% of all patients suffer a relapse within two years and recurrent tumours are often more aggressive and more difficult to treat than the initial tumours.(3,4,7) The availability of Glivec for this patient population addresses a previously unmet need for GIST patients.
Glivec is now licensed to be used to treat patients at significant risk of relapse following the removal of their tumour following approval from the European Medicines Agency (EMEA). The EMEA (the body responsible for the scientific evaluation of applications for European authorisation for medicinal products) says that patients who have a low or very low risk of recurrence should not receive adjuvant treatment.(1)
What is GIST?
GIST is a type of cancer called a soft tissue sarcoma i.e. a cancer of a supportive or connective tissue in the body such as fat, muscle, blood vessels, deep skin tissues, nerves, bones and cartilage.(8) GISTs develop primarily along the gastrointestinal tract (digestive system) and often spread within the abdomen.(9)
Although the cause of GIST is unknown,(10) 75-80% of people with GIST carry KIT mutations.(11) KIT is a protein in the body that plays an important role in the growth and survival of GIST.(12) In patients with GIST, the KIT protein can mutate and become over active.(5)
The normal role of KIT is to provide the 'signal' to cells in the body to grow and divide: this signal is not given continuously but can be turned 'on' and 'off' to limit cell division and growth. However, in people with GIST, a mutation in the DNA causes KIT to be continuously activated. Left 'on' all the time, KIT signals to cells to constantly grow and divide, driving the growth of GIST.(5)
Glivec in GIST
Glivec is a type of treatment called a tyrosine kinase inhibitor.(13) It works in GIST by targeting the KIT protein, binding to it and preventing it from sending continuous signals to the cancer cells to grow and divide.(14) Glivec has been available to treat people with unresectable GIST (GIST that cannot be removed through surgery) since 2002, but currently most people who have surgery to remove their cancer receive no further preventative treatment.
Glivec is now the only treatment approved to delay the return of this cancer, filling a previously unmet need for GIST patients.
References
1. EMEA opinion
http://www.emea.europa.eu/pdfs/human/opinion/Glivec_65949508en.pdf. Last
accessed
2. DeMatteo, R. et al. Adjuvant imatinib mesylate after resection of
localised, primary gastrointestinal stromal tumour: a randomised,
double-blind, placebo-controlled trial. The Lancet. Online publication
19/03/09. DOI: 10:1016/S0140-6736(09)60500-6.
http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673609605006.pdf?i
d=aeaa5a245ca1fddb:3c6bded9:1201d7429fe:-15be1237448848073. Last accessed
3. Van den Abbeele A., Benjamin R., Blanke C, et al. Clinical Management
of GIST. Recurrence patterns and prognostic factors for survival. Highlights
From the 2003 CTOS Annual Meeting and Helsinki GIST Symposium.
http://www.ctos.org/newsletter/GIST_Newsletter0404.pdf, last accessed on
4. Demetri GD, Benjamin RS, Blanke CD, et al. NCCN task force report: management of patients with gastrointestinal stromal tumor (GIST)- update of NCCN clinical practice guidelines. J Natl Compr Cancer Network, 2007; 2(suppl 1):S1-S26.
5. NHS Cancer improvement. Guidelines for the management of
gastrointestinal stromal tumours (GISTs).
http://www.cancerimprovement.nhs.uk/%5Cdocuments%5Cupper_gi%5Cpathways%5CGIST
_Mngmnt7.pdf, last accessed
6. Novartis Data on File (GLI-001-01)
7. Life Raft Group. Managing Initial Recurrence.
http://www.liferaftgroup.org/gist_recurrence.html, last accessed
8. Cancerbackup, Gastrointestinal stromal tumours(GIST);
http://www.cancerbackup.org.uk/Cancertype/Softtissuesarcomas/Types/GIST, last
accessed
9. Choi et al, Response evaluation of Gastrointestinal Stromal Tumors. The Oncologist 2008;13(suppl 2):4-7
10. Cancer Research UK, Cancer help, What is the treatment for GIST -
gastrointestinal stromal tumour? ;
http://www.cancerhelp.org.uk/help/default.asp?page=6161, last accessed
11. Rubin BP, Heinrich MC, Corless CL; Gastrointestinal stromal tumour. Lancet. 2007 May 19;369(9574):1731-41
12. Corless, CL et al. Biology of Gastrointestinal Stromal Tumors. J Clin Oncol 22:3813-3825.
13. Summary of Product Characteristics. Glivec. Last updated
14. Joensuu H, Fletcher C, Dimitrijevic S et al. Management of malignant gastrointestinal stromal tumours. Lancet Oncol 2002; 3: 655-64
(Due to the length of some of these URLs, it may be necessary to copy and paste the hyperlinks into your Internet browser's URL address field. Remove the space if one exists.)
Notes to Editors
About Glivec(R) (Glivec)
Glivec is approved in more than 90 countries including the US, EU and
Novartis AG provides healthcare solutions that address the evolving needs
of patients and societies. Focused solely on healthcare, Novartis offers a
diversified portfolio to best meet these needs: innovative medicines,
preventive vaccines, diagnostic tools, cost-saving generic pharmaceuticals
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positions in these areas. In 2008, the Group's continuing operations achieved
net sales of
SOURCE Novartis Oncology
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