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Cancer wonder-drug hits the heart

Spotlight falls on lasting effects of Gleevec.

A cancer drug hailed for its ability to rescue those dying from leukaemia could end up giving them heart failure, a study suggests. Doctors say that the side effects of cancer drugs are demanding more attention now that more and more patients are saved from the initial disease.

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Posted by Helen Pearson on July 23, 2006 06:00 PM |

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A Heartbreaking Research

The association of imatinib mesylate and cardiac dysfunction is not new and has been reported earlier (1), (2). The fact that this particular article has drawn so much public attention in such a short period of time once again demonstrates that it is not only what you publish, but where that makes an impact.

To me the research is truly heartbreaking because it gives evidence that the mechanism of imatinib cardiac toxicity is related to its main success, namely Bcr-Abl tyrosine kinase inhibition. Since even bigger hopes are being laid on the newer and ever more potent Bcr-Abl inhibitors nilotinib and dasatinib (3), (4) major cardiac safety issues emerge.

Nevertheless, it has been shown that the drug is effective by inhibiting both BCR-ABL and c-KIT in hematopoietic progenitors (5). Hence, in view of the Bcr-Abl importance for cardiomyocyte viability a further scrutiny of the relative importance of the inhibition of c-KIT signaling in both CML and c-KIT–positive AML seems pertinent.


(1) Imatinib Mesylate (Gleevec) Induces Mitochondrial Dysfunction and Caspase Activation in Cardiac Myocytes. J Card Fail 2005; 11(suppl): S126.
(2) BNP as a marker of the heart failure in the treatment of imatinib mesylate. Cancer Lett. 2005 Dec 30
(3) Nilotinib in Imatinib-Resistant CML and Philadelphia Chromosome–Positive ALL. N Engl J Med. 2006 Jun 15;354(24):2531-41.
(4) Dasatinib in Imatinib-Resistant Philadelphia Chromosome–Positive Leukemias. N Engl J Med. 2006 Jun 15;354(24):2542-51.
(5) Sole BCR-ABL inhibition is insufficient to eliminate all myeloproliferative disorder cell populations. Proc Natl Acad Sci USA 2004;101:17456-17461

Posted by: Ivan Boyadzhiev, MD | July 30, 2006 03:49 PM

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