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Glivec may lead to heart failure, says study

Patients taking cancer treatment should be monitored closely for heart trouble symptoms, urge researchers

Novartis' groundbreaking cancer treatment, Glivec (imatinib), may cause serious damage to cardiac tissue, researchers have warned.

The drug is regarded as the most effective treatment available to treat the blood cancer, chronic myeloid leukaemia (CML), in its advanced stages and has boosted survival rates for patients with the condition. Studies show it can keep anywhere between 80 and 90 per cent of CML patients cancer-free for at least five years.

A study published in the medical journal, Nature Medicine, by a team at Jefferson Medical College in Philadelphia, Tufts University School of Medicine in Boston and the University of Texas found evidence that10 patients taking the drug developed severe congestive heart failure.

ìGlivec is a wonderful drug and patients with these diseases need to be on it,î said lead researcher, Thomas Force in a statement. ìWe're trying to call attention to the fact that Glivec and other similar drugs coming along could have significant side effects on the heart and clinicians need to be aware of this. It's a potential problem because the number of targeted agents is growing rapidly.î

CML is linked to overactivity of an enzyme called the abelson tyrosine kinase (ABL) protein, which causes the out-of-control behaviour of white blood cells. Glivec turns off the enzyme, which also plays a role in keeping cardiac muscle cells healthy.

Force's team studied the ten patients who developed heart failure while taking Glivec and then tested the drug in lab dishes and in mice. It appears to be toxic to cardiac cells, they said.

Mice treated with Glivec developed left ventricular dysfunction, a key symptom of heart failure in which the heart fails to pump out blood completely.

Novartis said Glivec's benefits far outweighed the potential risks. Adding that the 10 patients who developed signs of heart failure had responded well to treatment for their symptoms.

ìAll Novartis-sponsored studies with Glivec are monitored for safety, and we are committed to conducting further clinical research to ensure safe and effective use of the drug in all patients,î the company said in a statement.

Glivec is one of a new generation of drugs that work on specific targets within the cancer cell. It was launched in 2001 and amassed global sales of $1.6bn in 2004. It is also approved for gastrointestinal stromal tumours (GIST), a rare type of stomach cancer.

The researchers warned that other drugs in the same class as Glivec, tyrosine kinase inhibitors, may also cause damage to the heart.

30th September 2008

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