Cancer Stem Cells and How to Get Rid of Them


If you have not yet heard of cancer stem cells (CSCs), often considered to be the real culprits in cancer, it is about time you do. CSCs are stem cells found in tumors. Drugs that target them are showing promise in clinical trials. More on that later; first, let’s introduce the concept of stem cells:

All normal tissues in our bodies develop from a small number of very special cells known as stem cells. Stem cells can divide a seemingly unlimited number of times. Continue reading…


The Coming Third Wave of Precision Cancer Medicines

“Targeted treatments for cancer have been extending and saving lives for more than 15 years—precision medicine isn’t a new idea in oncology. Now drugs pioneered on select, specific cancers are, one by one, finding new applications.

“The first wave of targeted drug approvals were for cancers associated with specific mutations. Herceptin (traztuzumab) led the way, approved in 1998. It’s a monoclonal antibody deployed against the HER2/neu receptor that is overabundant in some aggressive and early-onset breast cancers. Robert Bazell’s excellent book Her 2 tells the tale.

“In 2001 came the blockbuster Gleevec (imatinib), a small molecule that intercepts signals to divide. Erin Zammett’s My So-Called Normal Life with Cancer relates that story. A very young editor at Glamour magazine when a routine check-up revealed chronic myelogenous leukemia, Erin’s recovery was one of the first of thousands thanks to this now famous drug.”


An 'Utterly Broken' Drug Market: The High Cost of Surviving Cancer

“Lauren Baumann is one of the lucky ones.

“Though she has cancer, chronic myeloid leukemia, it is manageable, as long as she takes a daily pill called Gleevec. Gleevec is considered a wonder drug, turning Lauren’s leukemia from a death sentence to a disease she and thousands of others can live with. The problem is, even with health insurance and a full-time job, Lauren can’t afford the monthly co-pay for Gleevec. It can be as high as $2,000 a month — twice the average mortgage payment in the U.S.

” ‘I feel like you get punished,’ says Baumann. ‘I didn’t ask to get cancer; I didn’t ask to get sick. I was 26 and I was perfectly healthy.’ “


Switch from Imatinib to Nilotinib Improved Outcomes in Chronic Phase CML

Editor’s note: This story is about the results of a clinical trial – a research study with volunteer patients. The study tested a treatment for people with chronic phase chronic myeloid leukemia (CML) who had persistent minimal residual disease after long-term treatment with the drug imatinib (Gleevec). For the study, half of the 200 participants continued taking imatinib, and half of the patients switched to the drug nilotinib. It was found that the patients who switched to nilotinib had better outcomes than those who didn’t.

“Patients with chronic phase chronic myeloid leukemia who had persistent minimal residual disease after long-term treatment with imatinib achieved deeper molecular responses and undetectable disease when they switched to treatment with nilotinib, according to study results.

“The reduced disease burden associated with the switch to nilotinib may enable patients to enroll on treatment-free remission trials, researchers wrote.

“Timothy P. Hughes, MD, FRACP, FRCPA, head of the division of hematology at South Australia Pathology and clinical professor of medicine at University of Adelaide in Australia, and colleagues evaluated data from 207 patients with CML. All patients were in complete cytogenetic response yet had detectable BCR-ABL1 after 2 or more years of treatment with imatinib (Gleevec, Novartis).”


Drugs to Avoid in Patients on Tyrosine Kinase Inhibitors

Editor’s note: More and more people with cancer are being treated with drugs known as tyrosine kinase inhibitors (TKIs). As with any other drug, oncologists who prescribe TKIs must be aware of other drugs a patient is taking to ensure there will not be a dangerous drug-drug interaction. Researchers recently published a report outlining known and potential drug-drug interactions between TKIs and other drugs. Oncologists and patients may wish to take these into account when considering cancer treatment with TKIs.

“With the rapid and widespread uptake of tyrosine kinase inhibitors (TKIs) in oncology over the past several years, serious drug–drug interactions are an “increasing risk,” according a new report.

“To guarantee the safe use of TKIs, ‘a drugs review for each patient is needed,’ write Frank G.A. Jansman, PharmD, PhD, from Deventer Hospital in the Netherlands, and colleagues in a review published in the July issue of the Lancet Oncology.

“The review provides a comprehensive overview of known and suspected interactions between TKIs and conventional prescribed drugs, over-the-counter drugs, and herbal medicines.

“All 15 TKIs approved to date by the US Food and Drug Administration or the European Medicines Agency are evaluated.

“They are axitinib (Inlyta, Pfizer), crizotinib (Xalkori, Pfizer), dasatinib (Sprycel, Bristol-Myers Squibb and Otsuka America), erlotinib (Tarceva, Osi Pharmaceuticals), gefitinib (Iressa, AstraZeneca), imatinib (Gleevec, Novartis), lapatinib (Tykerb, GlaxoSmithKline), nilotinib (Tasigna, Novartis), pazopanib (Votrient, GlaxoSmithKline), regorafenib (Stivarga, Bayer), ruxolitinib (Jakafi, Incyte), sorafenib (Nexavar, Bayer), sunitinib (Sutent, Pfizer), vandetanib (Caprelsa, AstraZeneca), and vemurafenib (Zelboraf, Roche).”


Cost of Cancer Drugs Strongly Affects Treatment Adherence

A study of over 1,500 cancer patients showed that drug costs have a significant effect on whether patients stick to their treatment plan. The study’s subjects had been prescribed imatinib (Gleevec), a treatment for chronic myeloid leukemia, a type of blood cancer. Patients with higher co-payments were 42% more likely to skip doses and 70% percent more likely to stop taking Gleevec entirely. Missing only 15% of prescribed Gleevec doses significantly raises the chance of the cancer developing drug resistance and relapsing. The study also found drastic differences in out-of-pocket treatment costs, with co-payments ranging from nothing to $4,792 for a 30-day supply of Gleevec. The average co-payment amount more than doubled over the 9-year course of the study.


Cost of Cancer Drugs Strongly Affects Treatment Adherence

A study of over 1,500 cancer patients showed that drug costs have a significant effect on whether patients stick to their treatment plan. The study’s subjects had been prescribed imatinib (Gleevec), a treatment for chronic myeloid leukemia, a type of blood cancer. Patients with higher co-payments were 42% more likely to skip doses and 70% percent more likely to stop taking Gleevec entirely. Missing only 15% of prescribed Gleevec doses significantly raises the chance of the cancer developing drug resistance and relapsing. The study also found drastic differences in out-of-pocket treatment costs, with co-payments ranging from nothing to $4,792 for a 30-day supply of Gleevec. The average co-payment amount more than doubled over the 9-year course of the study.


Cost of Cancer Drugs Strongly Affects Treatment Adherence

A study of over 1,500 cancer patients showed that drug costs have a significant effect on whether patients stick to their treatment plan. The study’s subjects had been prescribed imatinib (Gleevec), a treatment for chronic myeloid leukemia, a type of blood cancer. Patients with higher co-payments were 42% more likely to skip doses and 70% percent more likely to stop taking Gleevec entirely. Missing only 15% of prescribed Gleevec doses significantly raises the chance of the cancer developing drug resistance and relapsing. The study also found drastic differences in out-of-pocket treatment costs, with co-payments ranging from nothing to $4,792 for a 30-day supply of Gleevec. The average co-payment amount more than doubled over the 9-year course of the study.


Gleevec May Help Preserve Fertility After Chemotherapy

Women who undergo chemotherapy often lose their fertility because the drugs used damage or kill their oocytes—immature egg cells stored in the ovaries. However, a recent study suggests that adding the cancer drug imatinib mesylate (Gleevec) to chemotherapy treatment may protect oocytes. Researchers treated mouse ovaries with the chemotherapy drug cisplatin (Platinol) either by itself or in combination with Gleevec, then implanted them into host mice. The oocytes from Gleevec-treated ovaries still suffered DNA damage from the Platinol exposure, but unlike oocytes treated with just Platinol, they did not die. Previous research suggests that the surviving oocytes could repair the damage over time after chemotherapy treatment ends. These findings offer the hope that Gleevec may help preserve fertility in chemotherapy patients.