A Triumph in the War Against Cancer- page 6 | Science | Smithsonian
"We're just seeing the start of matching patients with the right drug and seeing rapid improvements," says Dr. Brian Druker. (Robbie McClaran)

A Triumph in the War Against Cancer

Oncologist Brian Druker developed a new treatment for a deadly cancer, leading to a breakthrough that has transformed medicine

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(Continued from page 5)

CNN, the New York Times, “Good Morning America” and the Associated Press covered the breakthrough cancer pill.

Wave of the Future

After LaDonna Lopossa and her children said their goodbyes in February 2000, she eked out a few more days and made it to an appointment at OHSU. LaDonna’s oncologist and George had managed to get her into the second phase of the STI571 trial, which would enroll some 500 new patients at a dozen medical centers worldwide. She shuffled into the clinic on George’s arm. “What have we gotten ourselves into?” one of the nurses said, meaning LaDonna’s death, which appeared imminent, would count as a black mark against the drug. Her white blood count exceeded 200,000, more than 20 times normal. “There were no two ways about it,” Druker said. “You looked at her and she was in trouble.”

They examined her and gave her an STI571 pill. She threw it up.

The next morning, George and LaDonna awoke in her sister’s apartment in Portland and George made LaDonna a banana milkshake. Later that day, the STI571 pill stayed down. And the next, and so on.

“Within three weeks her spleen was back to practically normal,” Druker said. “She was feeling great. White count had come down. A Lazarus-like effect. It was truly miraculous.”

It was in May of that same year that LaDonna and George visited the cemetery in Winlock to place flowers on her mother’s gravesite, which is next to the plot LaDonna had bought for herself. “I’m supposed to be in that grave,” she said to George.

“Well,” he said, “since you’re not, why don’t we take a picture?”

By the late winter of 2001, Druker and his collaborators had pooled much of their STI571 data: in roughly 95 percent of patients, white blood cell levels had returned to normal, and in 60 percent the Philadelphia chromosome was not detected. The company submitted the results with its new-drug application to the FDA, which it approved in two and a half months—to this day the fastest drug review in the agency’s history.

Ten years ago this month, the U.S. government announced that the drug, which Novartis named Gleevec in the North American market (Glivec in Europe), would be available to CML patients. It was a defining moment. The previous century of cancer treatments—intermittently successful, based on trial-and-error testing, almost always agonizing—would be known to experts as “before Gleevec.” From then on was “after Gleevec,” the era of targeted therapy. At a Washington, D.C. press conference on May 10, the Secretary of Health and Human Services, Tommy Thompson, called the drug a “breakthrough” and “the wave of the future.” The then director of the National Cancer Institute, Richard Klausner, described it as “a picture of the future of cancer treatment.”

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