Signal transduction inhibition: changing paradigms in cancer care.
The development of the targeted signal transduction inhibitor imatinib mesylate (formerly STI571, [Gleevec]; Novartis Pharmaceuticals Corp, East Hanover, NJ) has prompted new ways of thinking about the treatment of chronic myeloid leukemia, other sensitive solid tumors such as gastrointestinal stromal tumors, and malignancies in general. The stresses associated with the extraordinary pace of testing and approval of imatinib mesylate provide lessons to government regulatory agencies, pharmaceutical companies, university researchers, professional societies, and the media in terms of their approach to cancer care, drug development, and dissemination of information. Such medical breakthroughs can generate an enormous, and occasionally overwhelming, volume of new information to be assimilated; misinformation and exaggeration should be avoided. Furthermore, in today's Internet age of information, a large fraction of a patient's medical knowledge and/or opinions may have been obtained and forged online, with input from other patients, and patients are clearly more informed about their illnesses and their options than in the past. The availability of imatinib mesylate has already profoundly changed the nature and sequence of treatment recommendations for patients with chronic myeloid leukemia, but a great deal still remains to be learned and new clinical trials must be designed to address numerous questions about the optimal use of this powerful new medication.
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Barbara Ann Karmanos Cancer Center Institute, Wayne State University School of Medicine, Detroit, MI, USA.
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D002986:Clinical Trials as Topic; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000068877:Imatinib Mesylate; D016898:Interferon-alpha / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000628:therapy; D009965:Orphan Drug Production; D010879:Piperazines / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D011743:Pyrimidines / Q000627:therapeutic use*; D015398:Signal Transduction / Q000187:drug effects*
D000970:Antineoplastic Agents; D001549:Benzamides; D004791:Enzyme Inhibitors; D016898:Interferon-alpha; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases