As of today, cancer patients in Britain have a new drug Sutent (sunitinib) available to them in the treatment for advanced kidney cancer and GIST, a rare gastrointestinal cancer. Sutent might become available in the future in the treatment of breast, lung and pancreatic cancers.Called a smart drug, it offers a two-pronged approach in starving tumors of nutrients and shutting down the signaling of an enzyme that tells cancer cells to multiply.
There is some discussion that because of the cost of the drug, $4,500 a month per patient, the National Health Service (NHS) is planning to limit its availability. Sutent will be prescribed after other more traditional cancer drugs and treatment have failed for kidney and gastrointestinal cancer patients.
1. Sutent is one of the multitargeted tyrosine kinase inhibitors, small molecules that act on multiple receptors in the cancerous cells. It inhibits several proteins involved in triggering replication in cancer cells.
Tykerb is likewise a small molecule drug. It may be a good reason why it could be better than Herceptin. Monoclonal antibodies like Herceptin are "enormous" molecules. These antibodies are substances that recognize and then attach to specific proteins on the "outside" of cancer cells. These very large molecules don't have a convenient way of getting access to the large majority of cells.
There is multicellular resistance, the drugs affecting only the cells on the "outside" may not kill these cells if they are in contact with cells on the "inside," which are protected from the drug. The cells may pass small molecules back and forth.
According to Chemical & Engineering News, targeted "small-molecule" therapies ruled at the annual ASCO meeting of oncologists. There is a trend away from the monoclonals to the small molecules, like Sutent and Tykerb.
However, these "smart" drugs do not work for everyone, and a test to determine the efficacy of these drugs in a patient could be the first crucial step in personalizing treatment to the individual.
Posted at 12:28PM on Aug 1st 2006 by Gregory D. Pawelski