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Gleevec


Maria

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I posted earlier in the month about Gleevec (in a response to a thread about chemo drugs) and didn't hear anything from anyone. Has anyone else heard anything about GLEEVEC?

We learned about it from my dad's onc who said that it is a "maybe" for treatment. In short, it a drug that was developed to "shut off" the c-kit gene in chronic myeloid lukemeia and had great success. Researchers located this same gene in a rare form of gastro-intestinal cancer for which there was no treatment -- and had great success. They have located this same gene in SCLC -- although not every SCLC patient has the c-kit gene present. Currently they think about 35-40% of SCLC has the c-kit gene although that number could be lower. They are now in the process of trying it out on SCLC patients.

They haven't yet determined whether my dad's SCLC has the gene present. In the meantime, I am doing research and seeing if anyone else has discussed this with their doctors. There are currently 2 clinical trials going on for first-line SCLC patients (Sloane Kettering is one location) and there is supposed to be one starting in conjunction with Mayo clinic for treating patients with recurrent SCLC.

Do a search on clinicaltrials.gov or the NCI website -- it is also known as "imatinib mesylate" ALSO, here is an article you should read about it too...

http://www.news.harvard.edu/gazette/200 ... eevec.html

It could be very promising -- ask your oncologist about this!

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  • 3 weeks later...

I did some research on Gleevec too. Looks promising. There are Phase I trials using Gleevec with chemo. I will let you know once I get more info. Or you can call 1-800-4-cancer and request info on the trials.

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There is also a phase II trial being done at Mayo (starting in April) and one being conducted at Sloan Kettering for recurrent extensive small cell lung cancer. My father is currently being tested for the c-kit gene and we are hoping that is present so that we will have Gleevec as an option. I will keep you all posted. Any other information or thoughts that people have -- please share them! thanks!

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  • 2 weeks later...

Maria, Thanks for quick reply. I called Mayo clinic and they have not started the trial yet, but it is for recurrences only. The one at Sloan-Kettering is in Phase I trial using Cisplatin & some other drugs but for those without prior chemo.

I am in the middle of chemo for extensive stage SCLC with Carbo & VP16. So, I will not qualify.

I will try to get my tumor tissue checked for c-kit or similar genes. If my onc says Gleevec might help me, I will try my best to get it. Will keep everyone posted.

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Guest kjbran@msn.com

Hello to all!!! Thank's for replies regarding C-kit and Topotecan. I just wanted to update you on conversation I had with representative at Mayo Clinic in Rochester Minnesota, regarding the Phase II study of Gleevec for recurrent SCLC. I found the study listed on cancer.gov. The minimal eligibility requirements are: *At least 18, *No more than one previous chemo regimen, *Measurable disease, *More than 3 weeks since chemo or surgery, *More than 2 weeks since radiation, and *no previos gleevec use. The study has been approved by NIH and will become active on May 2, 2002. It will be open to all North Central Cancer Sites (you can find those sites by going to http://ncctg.may.edu/) Once you get to that site click on Where are treating locations. There is a long list. I asked her if it had been successful in the phase 1 trials. She didn't have that information yet, but the rational for the study is this: approximately 70% of SCLC patient's tumors contain the C-kit gene--Gleevec is supposed to turn this gene off, thus stabilizing disease. (At least that's how I understand it. It has worked on CML and GIST). She further told me they do test for C-Kit with the tissue from the original biopsy used to diagnosis the disease. She said as far as she knew most labs do not throw away tissue samples. Part of the study protocol will include testing for the gene for qualification. There were other eligibility requirements as well, but she didn't have all of them. She suggested I wait until 4/28/03 to call one of the sites listed on the North Central list to let them know I was interested. They will all be told the Study will become active on 4/23/03 at a meeting that is being held. Each site has their own board that determines time tables for starting etc...but if they know someone is interested they may hurry it along. I wish this study were available now. My mom's has recurred, and we don't want to wait until May to start treatment. If we were sure she met all the study eligibility requirements we might consider waiting. But time is of the essence and the nasty stuff is back and growing. We are starting Topotecan on Monday 4/14/03. I hope this information helps someone.

Thanks for the prayers and support

Julie

Mom dx 8/02 Extensive SCLC lung, liver, rib, brain

Cisplatin & Etoposide 8/02-1/03

Brain radiation 9/02

Recurrence 4/03

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  • 4 weeks later...

Julie,

I got my tumor tested for c-kit gene and I am very positive. My Onc is very eager to get me started on Gleevec, with or without the trial. The site mentioned by you (http://ncctg.may.edu) for the list of the Gleevec trial sites is not correct. Do you mind giving me / us the correct site address, Much obliged. God bless.

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David M,

The site is probabably "mayo" instead of "may" -- a bet it was a typo. Also, look into Sloan Kettering (NYC). When I was investigating for my dad, I spoke with people there and they are currently using Gleevec in a phase II trial (in case you don't want to wait until Mayo starts their trial)

I wish you luck. It is a good sign that you have a high level of c-kit --which they think correlates to how effective gleevec will be.

I was very hopeful for this for my dad. Sadly, he passed away before we could start him on this. It still doesn't seem real that he is not here. But, I would really like to hear how you do on Gleevec -- and again, wish you all the best. It has been promising for other cancers that did not have really any treatments (GIC)..so my prayers are with you that it turns out to be a new promise for SCLC --- Lord knows, something is needed!

God bless.

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  • 4 weeks later...

David M.

Sorry it has taken me so long to get back. I was on vacation etc... the website I listed was the one where you can find participating sites. I found the Gleevec trial on cancer.gov. I called the Mayo Clinic cancer communications (507) 284-2241 to find out additional information about the Phase II study for Gleevec in recurrent SCLC. Call them -- the trials should have started. It was being conducted at multiple sites--I hope this helps.

Julie

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I posted this a few places ... but it seemed like it is a topic of interest

Lung Cancer. 2003 May;40(2):173-80. Related Articles, Links

Frequent overexpression of the c-kit protein in large cell neuroendocrine carcinoma of the lung.

Araki K, Ishii G, Yokose T, Nagai K, Funai K, Kodama K, Nishiwaki Y, Ochiai A.

Pathology Division, National Cancer Center Research Institute East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Chiba, Japan

Overexpression of receptor-type tyrosine kinases in various cancers is associated with an aggressive tumor phenotype and poor outcome, but their expression had never been evaluated in large cell neuroendocrine carcinoma (LCNEC) of the lung. In the present study, we investigated the expression of three receptor tyrosine kinases, epidermal growth factor receptor (EGFR), c-erbB-2, and c-kit protein, by comparing surgically resected 40 LCNECs with other neuroendocrine (NE) lung tumors: 9 typical carcinoids (TCs), 5 atypical carcinoids (ACs), and 13 small cell lung carcinomas (SCLCs). None of the NE lung tumors showed expression of EFGR or c-erbB-2, but c-kit was overexpressed in 55% of the LCNEC tumor cells and 46% of the SCLC tumor cells. None of the clinicopathologic factors in either the LCNEC or SCLC patients correlated with c-kit overexpression. The finding that c-kit expression in LCNEC is similar to its expression in SCLC suggests that inhibition of c-kit may be effective as a therapy targeting LCNEC as well as SCLC.

PMID: 12711118 [PubMed - in process]

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