Chapter 1: What anniversary is being celebrated in this episode?
For a growing number of women, single motherhood feels like the right choice. She locked eyes with me and that was the moment that I knew we were about to have one hell of a life together. On the Sunday Story, how these single mothers are making it work. Listen now to the Sunday Story from the Up First podcast on the NPR app.
You're listening to Shortwave from NPR. Hey, short-wavers. Emily Kwong here with NPR Pharmaceuticals correspondent Sydney Lupkin. Hello. Hi, Emily.
So this weekend marked a very important anniversary.
Was it our anniversary? We have been friends for a long time.
No. Oh. Not our friendiversary, Emily. No. the anniversary of a pill that revolutionized cancer care. Oh, that's way better. Not that I don't love you. What pill? So the drug is called Gleevec, and May 10th marks 25 years since the Food and Drug Administration first approved it. Okay. So Gleevec, why is this pill such a big deal? Well, it's considered one of the first targeted cancer therapies.
And what it really did was make some cancers that were once fatal not so fatal anymore. Survivable. Wow, that is a big deal.
Yeah.
Yeah. And I talked about it with this guy in Atlanta. His name is Mel Mann. And he told me that in 1995, he was dealing with some back pain and fatigue, but it wasn't really clear why. Then, after an MRI showed what was going on with his bone marrow, he was diagnosed with chronic myeloid leukemia, a kind of blood cancer. He was 37 at the time and had a five-year-old daughter at home.
The doctors told him he had three years to live.
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Chapter 2: Why is Gleevec considered a revolutionary cancer treatment?
So after his diagnosis in January 1995, Mel starts doing bone marrow drives, hoping to find a match and get a life-saving bone marrow transplant. But at the time, if you were Black, you had such a low chance of finding a match that he knew it was kind of an impossibility.
And I would take my daughter with me. So she understood that I needed a match to live. In fact, one of the drives, she couldn't be more than probably still five. She says, Daddy, I can't see why you can't find a match. All the blood looks the same to me.
But after all this searching, Mel added thousands of people to the registry, but he didn't find a match for himself.
Immediately, you're going to think of your family. And I thought, you know, how old she's going to be at the end of three years. And it was eight years. And, you know, I was trying to bargain for more.
So he started participating in clinical trials for experimental treatments still in development. They would work for a few months and then stop. He outlived his expiration date, but wasn't doing well.
By then, I was, like, really tired. You know, I would sleep for eight hours, drink two cups of coffee, wake up and feel like I never went to bed. I had become, like, really lost a lot of weight. So I asked the doctor, were there any more drugs?
And there was another one, Gleevec, though, of course, it was still being studied and didn't have that name yet. Mel started the drug in August of 1998. By the next June, Emily, he was running a marathon in Anchorage, Alaska.
And I did it in a pretty decent time, too.
Today on the show, Gleevec and how it ushered in a new era for cancer care. You're listening to Shortwave, a science podcast from NPR. Okay, Sydney, today we are talking about a revolutionary cancer drug. Developing a new drug, of course, is not easy. So what is the origin story of this one, Gleevec?
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Chapter 3: What was the history behind the development of Gleevec?
But he ultimately had to leave his job in Boston and move across the country to Oregon Health and Science University to really actually pursue it. Yeah. He's like, this is big science. I got to take a risk here. Right. Was it worth it? Well, he says that within six weeks of arriving, he was testing five compounds from the drug company that would become Novartis in his lab.
One of them was Gleevec. It was a compound discovered by scientist Nicholas Leiden, and it worked, at least in the lab.
The reality is I wasn't just a researcher. I also had patients, many, many patients who believed in me, thought that this was a potential way forward for them. And it allowed me to have enough courage to be their mouthpiece and voice to lobby to get this drug into clinical trials.
So it sounds like he was in a race against time, really, to try to save these patients' lives.
Yeah, exactly. And these trials were also unique because they only included patients with this specific kind of leukemia.
Wait, so was that not common in cancer drug trials? No.
Before this trial, cancer drug studies would include patients with all kinds of cancer, and they just sort of hoped, that the drug worked for some of them. They would just lump them all together? And for a few, it would become the standard of care. It would work. But for most people, the drug wouldn't work.
That's so interesting. But I guess Brian's trial, he wanted to focus just on this type of leukemia because his pill was designed to target that cancer and the thing causing the cancer. Exactly.
Within six months, every CML, which is the abbreviation for chronic myeloid leukemia, Patient taking more than 300 milligrams responded to the treatment. Every patient? It was unheard of, Emily. And because it was 1999, it was also the early days of blogging and internet chat rooms. So the patients were talking to each other.
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Chapter 4: How did Mel Mann's story illustrate the impact of Gleevec?
That discovery was funded by the National Cancer Institute, which is part of the NIH.
So this, even though it got approved in 72 days... That's because of years of work ahead of it and layers of cooperation from so many different groups.
cooperation and taking on risk. Remember, Brian Drucker moved across the country. The drug company that would become Novartis took on the financial risk of doing the expensive clinical trials. The patients took a risk trying a new drug, and then a whole bunch of people moved to heaven and earth to speed up the approval time. All of this changed medicine.
You can think of it as really ushering in this era that we have now of of targeted therapies, targeted cancer drugs on the market. There's now over 100 targeted cancer drugs on the market, which in many cases have meaningfully improved overall survival and quality of life.
Though I should add that Gleevec was also considered incredibly expensive when it launched at $26,000 a year. And that meant even more money back in the early 2000s.
Yeah.
The drug is now generic and much cheaper.
So Gleevec is still being used today.
Yep, it's still used. Brian still prescribes Gleevec and the second, third, and fourth generation drugs that came after. And he's still able to tell patients that they'll be able to live a normal life. He told me about one patient who had leukemia as a child and started taking Gleevec. Eventually, she was able to come off the drug with no recurrence of her cancer, and she now has two kids.
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