Jueves 15 de Agosto de 2002, Ip nş 22

Revolutionary cancer drug to be given to leukaemia sufferers
Por James Meikle

A groundbreaking cancer drug is to be made more widely available on the NHS, to the delight of patients, doctors and cancer charities.

Glivec, the first of a new class of drugs that "switch off" control systems that threaten the body, could soon be given to about 950 patients a year suffering from chronic myloid leukaemia, a rare bone marrow cancer, after a change of heart by the national institute for clinical excellence (Nice), which monitors the cost-effectiveness of drugs for the NHS in England and Wales.

Pressure from patients and cancer specialists and new evidence of its extraordinary power have convinced advisers to Nice that it should be available for some patients at all stages of the disease.

In May, the organisation had signalled that it should only be used for those in the later, accelerated stage of the disease, thought to affect about 2,660 people at any one time.

The Leukaemia Research Foundation's scientific director, David Grant, said: "Glivec offers hope to all leukaemia patients and scientists because it is the first in a new class of drugs designed to target the unique nature of a particular cancer cell. We believe in time it will be seen to be a landmark treatment in the fight against this life-threatening disease."

He said 90% of patients given Glivec in the early, chronic stage, after interferon treatment had failed, had seen improvements in their condition.

Dr Richard Sullivan, of Cancer Research UK, said patients had "real hope for a better quality of life and increased survival. Not only are there fewer side-effects with Glivec compared with existing treatments, but it is also likely that the medication will extend life by stopping the disease from spreading."

The latest recommendation of the Nice appraisal committee is expected to be confirmed in October and there is the prospect in future of more patients being offered the drug, which can cost up to £28,400 for a year's treatment for each patient during the early phases of the disease and as much as £38,000 in the late stages. Nice is about to consider whether Glivec should become a more widespread frontline treatment for chronic myloid leukaemia, or CML.

This cancer, usually linked to an abnormality in a chromosome, develops as white blood cells became cancerous and multiply. This leads to a reduction in the oxygen-carrying ability of the blood. Bone marrow transplants in the early stages of illness, especially in children, offer a good chance of recovery and are the only way of achieving a cure, but it is difficult to find suitable donors.

Other treatments by chemotherapy can only delay progress of the disease but Novartis, the manufacturer of Glivec, claims impressive results in improving survival rates, and medicine regulators took the unusual step of licensing the drug before the completion of clinical trials.

The drug, taken orally with a meal, blocks signals in the white cells that lead to their uncontrollable proliferation, and is seen as a textbook example of how drugs might be developed from scientists' better understanding of our genetic make-up.

Patient support groups in Britain have been highly critical of the extra hoop of cost-effectiveness demanded by the NHS, pointing out that the drug has quickly become widely used in many other countries.

Here the latest advice still means that it will, in the early stages, only be given to patients who either do not respond to, or have to be taken off, therapy with interferon-alpha. But even this extra use might add nearly £16m to the annual drugs bill in England and Wales.

Andrew Dillon, the chief executive of Nice, said the "open and consultative process" by which it appraised drugs meant there was always the chance that final determinations might differ from provisional recommendations.


  13/08/2002. The Guardian.