8 replies to this topic

[CallMeLucky]

"A final note: I said CML was a "rare" disease, and that was true in the / era  before Gleevec. The incidence of CML remains unchanged from the past: only a few  thousand patients are diagnosed with this form of leukemia every year. But the  prevalence of CML--the number of patients presently alive with the disease--has  dramatically changed with the introduction of Gleevec. As of 2009, CML patients  treated with Gleevec survive an average of thirty years after their diagnosis.  Based on that survival figure, Hagop  Kantarjian [of MD Anderson] estimates that within the next decade, 250,000  people will be living with CML in America, all of them on targeted therapy. Druker's  drug will alter the national physiognomy of cancer, converting a once rare  disease into a relatively common one. (Druker jokes that he has achieved the  perfect inversion of the goals of cancer medicine: his drug has increased the  prevalence of cancer in the world.) Given that most of our social networks  typically extend to about one thousand individuals, each of us, on average, will  know one person with this leukemia who is being kept alive by a targeted  anticancer drug."

[janner25]

That's interesting...yesterday I saw these stats:

CML makes up 11% of leukemia patients.  There are 24,800 people living with CML in the U.S. In 2010, 4,870 people were newly diagnosed - 2,800 men and 2,070 women.

With all these new meds, I wondered why that number was so low in the U.S.  But what I forgot, is how new the 'wonder drugs' are.  It will be interesting to see that number next year.

[jrsboo]

Having had lots of statistics classes, my biggest question is: Based upon what evidence of a ten year old drug can they possibly extrapolate that people will live 30 years?

Just an observation from someone who hopes they are right.

[cometbro]

Thats a great question jrsboo.  Could they be using the fact that previous drugs worked really good for some specific people, and then when Gleevec came out, continued to live off of that, cumulating to 30 years?  That might be saying a little bit too much.

Hopefully though, 30 years is too much for us and that we can all be CML free before then.

[CallMeLucky]

I'm not 100% certain, but I recall reading about this study on Gleevec done by a mathematician.  Their extrapolations showed that given the way most people respond to the drug, the 30 year estimate is highly likely.  I've heard Druker use that number as well.  So while no one can say for certain one way or the other, it seems likely.  It appears that individuals are less likely to have disease progression the longer they are stable on the drug.  I think the Gleevec trial showed that by something like 5 years if the patient hadn't progressed to another stage, they weren't going to.

Some others like Trey know the details of the trials better than I do, but the overall message is that with today's treatments, it is very likely an individual with CML will not die from the disease.

[Trey]

It is the trajectory of the patients that have been on Gleevec since 1999 - 2001 that is so compelling.  Almost all of them keep doing better and better, with minimal chance of any relapse after the first few years.  And we have even "better" drugs now, with more coming along soon.

And at some point it is more Newtonian than Euclidian.  "A body in motion tends to stay in motion unless acted upon by an unbalanced force..."

http://en.wikipedia...._laws_of_motion

[rickpister]

Out of all the leukemia's, where does CML rank on the lethal scale?  

[Trey]

CML changed from near most deadly to near least deadly for those diagnosed.  CLL never was considered very deadly, and it remains so.

CML deaths rates have declined dramatically since Gleevec was approved:

http://www.espectado...umentos/CML.pdf

[CallMeLucky]

Without treatment, it would be 3rd out of 4.  The acute leukemia's move very quickly and CLL moves very slow.  CML survival wihtout treatment would likely be a few years.

When you add current treatment into the mix (TKI drugs), CML probably has the best prognosis for long term survival.