The drugs that we take for CML are they really chemo drugs???
Posted 26 March 2012 - 12:32 AM
The drugs that we take for CML are they really chemo drugs???
Posted 26 March 2012 - 04:43 AM
They are not considered as chemo, they belong to the category of targeted therapy
wikipedia says :
Targeted therapy is a type of medication that blocks the growth of cancer cells by interfering with specific targeted molecules needed for carcinogenesis and tumor growth, rather than by simply interfering with rapidly dividing cells (e.g. with traditional chemotherapy). Targeted cancer therapies may be more effective than current treatments and less harmful to normal cells.
Basically targeted therapies are more accurate and specifically target the cancerous cells (that's why side effects are usually less strong compared to chemotherapy).
Posted 26 March 2012 - 09:30 AM
The term "chemotherapy" means literally "chemical therapy", but the usage of the term is reserved for potent agents that are not targeted. As a "biologically targeted therapy", Gleevec is more like a bullet, and chemo is more like a shotgun. If someone took chemotherapy every day, they would not survive very long, since it kills a lot of good cells along with the bad. Also, you will never hear Dr Druker, Dr Shah, Dr Goldman, Dr Talpaz or any of the most notable CML experts call these CML drugs "chemotherapy". Dr Druker's bio makes a point to distinguish Gleevec from chemotherapy:
"He began treating patients in a community cancer clinic half a day a week—an experience that cemented his desire to develop targeted drugs to attack cancer cells without the harmful side effects of chemotherapy."
(See para 3)
If someone says the "broader" use of the term would apply to TKIs, then it would also apply to aspirin and every drug that is not a naturally occurring substance.
Posted 26 March 2012 - 10:22 AM
It depends on the context in which it is being used. Since there are many laws being passed about "oral chemotherapy" it would be to our disadvantage in many cases for these drugs to not be considered chemotherapy. Something I think the lawyers will be happy to fight over.
In some ways it is kind of like asking if a tomato is a fruit or a vegetable. From a biological standpoint a tomato is a fruit, however the supreme court of the United States ruled that a tomato is a vegetable in response to a tariff case resulting from fruits and vegetables being taxed differently.
So you could argue the issue from many points of view or contexts, get a different answer and still be right. When I get my Gleevec from my mail order pharmacy it comes in a bag that says "chemotherapy drug" on it, so what does that mean? According to the American Cancer Society "Oral chemo is any drug you are taking by mouth to treat cancer."
You need to define the context in which you are asking the question in order to get the proper answer.
Posted 26 March 2012 - 11:11 AM
Hi Lucky: I am on the same page as you with regard to the TKI drugs. You explained it very simple. My packaging also says Chemo Drug when it comes. I always say Oral Chemo too. When I started on Gleevec in the trial, I was told that it would not kill any normal cells only cancer cells and that is what causes all the joint pain in the beginning.
To me if its killing something, then its a Chemo. I am not good with all the medical details, but I still think its a Chemo.
Posted 26 March 2012 - 03:08 PM
I think it depends on how strictly you define chemotherapy. My onc says TKIs are biological agents rather than chemical agents. However, I am assigned to the nurse who manages the oral chemo patients, I received instructions for taking chemo drugs, my Tasigna boxes are labeled as chemotherapy, the med tech who usually does my blood draws refers to my brain fog as chemo brain. It seems to me that TKIs are informally called chemo drugs, but strictly speaking, they are not.
Posted 26 March 2012 - 03:25 PM
Call Me Lucky,
I find that interesting in that sometimes the insurance will refer to it as a oral chemo drug.
Posted 26 March 2012 - 07:56 PM
If Dr Druker refuses to call TKI drugs chemotherapy, then so shall I.
Posted 26 March 2012 - 08:16 PM
I agree with Trey and in a detailed conversation I would always call them targeted therapy or something similar. However, when talking to somebody who doesn't do medical/biological speak I say that I'm on a drug that is kinda like chemo: it's better than chemo in that it has fewer side effects and has a very high success rate, but also worse than chemo because it has no end date.
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Posted 26 March 2012 - 08:34 PM
No, traditional chemo kills all cells that undergo cell division. Because cancer cells have rapid turnover, they divide more frequently, thus chemo disproportionately kills cancer cells compared to normal healthy cells. But it still kills normal healthy cells.
We are on a targeted molecular therapy, meaning the drug targets an active site of the oncogenic protein ONLY. Healthy normal cells do not have the binding pocket of bcr-abl, and thus are not affected. So TKIs are very different from chemo, and are not considered to be such. They target a specific molecular site to treat a specific disease. Very unlike chemo. In fact, there are other targeted drug therapies to treat different diseases (not cancer) and we don't call those chemo.
To the extent you find it in product literature, I think that is more for marketing, both to consumers (who after all are cancer patients used to hearing about chemo) and to insurance companies. It wouldn't surprise me to hear that Novartis marketed this as a new kind of chemo to get the insurance companies to pony up. Chemo they could understand. Targeted therapy sounds too experimental and risky to cover.
My two cents,
Posted 27 March 2012 - 04:23 PM
I think it may have been on a different CML forum (I know, I'm such a tart) that I read someone's perfect answer to this question. Chemotherapy drugs kill the cancer cells but also kill healthy cells. TKI's kill the cancer cells but don't kill the healthy cells, they just really p#ss them off.
Posted 27 March 2012 - 07:00 PM
Regarding " It wouldn't surprise me to hear that Novartis marketed this as a new kind of chemo to get the insurance companies to pony up. Chemo they could understand.""
For Insurance purposes, it is important for them & me to use the word Oral Chemo to code and pay for certain medical treatment, otherwise I would need to pony up or put out more money! When I call my insurance company they wouldn't understand Target Drug, neither would they pay!
Posted 27 March 2012 - 08:45 PM
Yep, I hear you on the insurance part. I'm all for coding that gets the insurers to pay.
From a chemist's perspective, I roll my eyes at the term chemotherapy, since it's derivative of chemical therapy. Heck, the vast majority of drugs are chemicals, hence chemical therapy. Chemotherapy should have a more descriptive name, like chemocide, to indicate its a chemical killing machine.
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