Biotechnology Healthcare - June 2008 - (Page 17) PERSONALIZED MEDICINE What the Devil Is Personalized Medicine? Bob Carlson, MHA, Senior Contributing Editor R obert M. Roy is not the kind of guy who calls in sick. For one thing, he’s a self-employed corrosion consultant who teaches and travels the world, inspecting ships, bridges, nuclear power plants, and other infrastructure. He’s also ex-Special Forces, with a “high pain threshold,” as he puts it. Roy, who had just turned 50, had been feeling unusually fatigued after he returned from Belgium in 2000, but he figured it was his hectic travel schedule. It wasn’t. Doctors at the University of Texas M.D. Anderson Cancer Center, in Houston, told him he had blast phase chronic myelogenous leukemia (CML) and needed to be hospitalized immediately. Hydroxyurea and chemotherapy were the standard of care back then, and while the hydroxyurea seemed to stabilize his white cell count, Roy developed esophageal and throat ulcers and lost 40 pounds. When the U.S. Food and Drug Administration approved imatinib mesylate (Gleevec) the following year, Roy was switched to that drug. Imatinib worked for two and a half years, but, as sometimes happens, the disease mutated into a form resistant to it, and Roy was back to square one. Roy’s doctor, Jorge Cortes, MD, deputy chair of the department of leukemia at M.D. Anderson, was principal investigator in trials of dasatinib (Sprycel), a potent investigational CML drug. Cortes enrolled Roy in phase 2 trials of dasatinib, and six weeks later, Roy’s CML was in remission. Dasatinib was approved in 2006. “That was in February of 2005, and I’ve been on Sprycel ever since,” Roy says. “I am traveling the world again, and Sprycel makes it possible for me to do that. I don’t know how it works, but I know it works.” tities in the relatively new category of personalized medicine. What’s personalized about imatinib and dasatinib is that they target the root cause of CML and Philadelphia chromosome-positive acute lymphoblastic leukemia by blocking the abnormal activity of a gene that controls cell proliferation. In contrast, most drugs on the market today are “one-size-fits-all” medications that may or may not be effective in certain types of patients, and carry the potential for side effects that outweigh any benefits provided. Roy’s experience with hydroxyurea is a good example. Sometimes, the side effects turn out to be an unexpectedly high rate of injury or even death, which often results in the withdrawal of the drug from the market. Jac Depczyk/The Image Bank/Getty Images WHAT MAKES IT PERSONAL? Roy is one of thousands saved by imatinib and dasatinib and one of millions who have been helped by a new generation of personalized drugs that have saved lives, enhanced quality of life, and perhaps even reduced the overall cost of care. The dosage form of imatinib and dasatinib happens to be a tablet, but personalized drugs also can be injected or infused biologics. Together, these kinds of drugs and other interventions are among the first enMAY/JUNE 2008 · BIOTECHNOLOGY HEALTHCARE 17
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.