SAN ANTONIO (Nov. 13, 2009) — The NBA’s all-time leader scorer, Kareem Abdul-Jabbar, revealed this week that since December 2008, he’s been taking an oral medication to treat a rare cancer of the blood known as chronic myeloid leukemia (CML).
It’s possible that this medication was developed by San Antonio hematologist Frank Giles, M.D., M.B., professor of medicine at the Cancer Therapy & Research Center at the UT Health Science Center at San Antonio. While an Associated Press news report did not name the treatment, it mentioned that Abdul-Jabbar is a paid spokesman for Novartis, one of the world’s largest pharmaceutical companies. Novartis makes two of the leading drugs to treat CML, imatinib (sold as Gleevec) and nilotinib (sold as Tasigna). Dr. Giles has been one of the leading scientists involved in developing nilotinib from its earliest stages.
“Had Kareem Abdul-Jabbar been diagnosed with chronic myeloid leukemia 40 years ago, his chance of survival would have been close to zero,” said Dr. Giles. “Today the survival rate is over 95 percent. That improvement is attributable to imatinib.” Imatinib, or Gleevec, has long been the frontline treatment for CML, though research results recently released suggest that nilotinib may be more effective.
Abdul-Jabbar is quoted as saying his doctor told him he had a very good chance to live out his life without making any drastic changes to his lifestyle. The 62-year-old special assistant to the Los Angeles Lakers said he hasn’t had to cut back his level of coaching activity or adjust his diet.
When Gleevec was released in 1998, it was considered a wonder drug, Dr. Giles said. “Gleevec showed that if you can identify a critical kinase or enzyme to target, you can develop therapy that affects only the cancer and leaves normal cells largely alone.”
The problem was that while patients treated with Gleevec had a 95 percent survival rate after five years, about 15 percent of them became resistant to the drug or intolerant of it. Dr. Giles and his team created Tasigna as a second-line therapy for patients who no longer benefited from Gleevec. The team took the drug from the laboratory through approval by the Food and Drug Administration in October 2007.
Novartis, eager to learn if Tasigna might work better than Gleevec as a frontline therapy, developed a large global randomized trial comparing the two drugs. On Oct. 20, 2009, Novartis announced that Tasigna produced “faster and deeper” responses than Gleevec, and that patients tolerated the drug well.
The trial results are significant, said Ronan Swords, M.D., assistant professor of medicine, who is leading another study of nilotinib at CTRC. This project, part of an international study, is evaluating whether nilotinib used as a frontline treatment will be as effective at a lower dose, 300 mg rather than 400 mg twice a day, the dose studied most recently.
“Nilotinib appears to be the next step in curing CML,” said Dr. Swords. “The chances of patients developing resistance to nilotinib are reduced significantly because patients respond more dramatically and more quickly than those taking imatinib. The sooner the disease goes into remission, the better our chance for a cure.”
About 5,000 people are expected to be diagnosed in 2009 in the United States with CML, one of the four main types of leukemia, according to the Leukemia and Lymphoma Society. Symptoms tend to develop gradually and include the following: tiring more easily, shortness of breath doing usual day-to-day activities, pale skin color, enlarged spleen leading to a “dragging” feeling on the upper left side of the abdomen, night sweats, an inability to tolerate warm temperatures and weight loss. The society cautions that most of these signs and symptoms are common to other illnesses, and that most people who have them do not have CML.
The Cancer Therapy & Research Center (CTRC) at The University of Texas Health Science Center at San Antonio is one of the nation’s leading academic research and treatment centers, serving more than 4.4 million people in the high-growth corridor of Central and South Texas including Austin, San Antonio, Laredo and the Rio Grande Valley. CTRC is one of a few elite cancer centers in the country to be named a National Cancer Institute (NCI) Designated Cancer Center, and is one of only three in Texas. A world leader in developing new drugs to treat cancer, The CTRC Institute for Drug Development (IDD) is internationally recognized for conducting the largest oncology Phase I clinical drug trials program in the world, and participates in the clinical and/or preclinical development of many of the cancer drugs approved by the U.S. Food & Drug Administration. For more information, visit the Web site at www.ctrc.net.