Pic Of The Day
Posted by rob on June 25, 2005 under Uncategorized | 
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Austin Hilsmier, 3, from Chicago, looks back at his mom as he plays in Chicago’s Crown Fountain at Millennium Park
Pic Of The Day
Posted by rob on June 24, 2005 under Uncategorized | Be the First to Comment
A model presents a creation by Kosovo Albanian designer Lejla Feta during the first fashion show of Islamic female clothing in Pristina.
Pic Of The Day
Posted by rob on June 23, 2005 under Uncategorized | Be the First to Comment
A digital particle image of Rufous hummingbird hovering is seen in this undated handout. Hummingbirds hover by flapping their wings a bit like insects and a bit like other birds, and now a super-fast camera has made an image of the technique, scientists reported, June 22, 2005. Researchers used digital particle imaging velocimetry (DPIV), to study the aerodynamics of hummingbird hovering. DPIV couples a digital camera that uses a laser light source and a computer to track circulating microscopic oil droplets seeded in the air. The system allows scientists to follow the movement of individual particles when air is circulated by the bird’s wings.
Pic Of The Day
Posted by rob on June 22, 2005 under Uncategorized | Be the First to Comment
Greek soccer fans smile before their teams Confederations Cup soccer match against Brazil in Leipzig, Germany.
New Groups For AMN107 And BMS-354825 Clinical Trials
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We have set up new groups on CMLHope Groups for participants
and others who are intersted in the AMN and BMS clinical trials.
This will provide a means of communication for those who currently
may be enrolled in these trials or who may wish to consider them
in the future. We will be setting up additional groups as other new
drugs from Novartis, BMS, Pfizer, and other companies may go
into clinical trials in the future.
[AMN107]
A group for the AMN107 clinical trial.
To subscribe send an email to AMN107-subscribe@cmlhope.com or
visit the web site at http://groups.cmlhope.com
[BMS354825]
A group for BMS354825 clinical trial
To subscribe send an email to BMS354825-subscribe@cmlhope.com or
visit the web site at http://groups.cmlhope.com
Marrow drive will help patient
Posted by rob on June 21, 2005 under Uncategorized | Be the First to Comment
Wingdale mom seeking match
By Elizabeth Lynch
Poughkeepsie Journal
Dozens of people have agreed to a give a blood sample in the hope they might be able to help a 39-year-old mother of two who needs a bone-marrow transplant.
Lynne Dagata-Grist of Wingdale went for a routine checkup in April. She told her doctor she was feeling tired and rundown but had written the problems off as symptoms of another, ongoing disease.
That is, until her doctor ordered an in-depth blood test and found she had extremely high white-blood-cell counts and her red-blood-cell count was so low she was at risk for heart failure.
Three days later, she had a bone-marrow biopsy and discovered she had chronic myelogenous leukemia.
“I’m lucky I caught it when I did,” she said.
Her co-workers at Taylor Oil will sponsor a bone-marrow drive July 9 to help find a donor.
Disease strikes adults
Chronic myelogenous leukemia is an acquired form of blood cancer typically seen in adults. For Dagata-Grist, that means her children, who will be 12 and 14 years old in August, aren’t at an increased risk for the disease.
There are about 4,600 new cases diagnosed annually in the United States. The disease is caused by a chromosomal anomaly that might be caused by overdoses of radiation, although research is ongoing.
To be a bone marrow donor, an individual must undergo a finger-stick blood test. The blood does not have to match in type, but there must be a perfect match to the six antigens. The human leukocyte antigens are inherited, three from each parent. They are what produces the body’s defense system. Siblings tend to match about 25 percent of the time.
Dagata-Grist’s brother is being tested to determine if he is a match.
Meanwhile, she is taking a relatively new drug called Gleevec.
“My counts are almost back to normal,” Dagata-Grist said. “I’m 90 percent better.”
She must take the medication until she can undergo a bone-marrow or stem-cell transplant.
If her brother is not a match, then Dagata-Grist will be added to the transplant waiting list.
There are some 5.5 million on the marrow donor registry, said Sueanne Paprocki, program coordinator national Marrow Donor Program.
Annually, there are about 2,200 marrow transplants performed. But there are an estimated 35,000 people who need a transplant, 70 percent of who cannot find a match on the registry.
In the Dover Plains area, some 68 people have joined the registry and nearly $8,000 has been raised to cover the $65 cost for the blood and antigen testing.
The cost “probably is a good reason why people don’t just go out and get tested,” said Karen Murphy, a friend and co-worker of Dagata-Grist, who is helping to coordinate the marrow drive.
The Marrow Foundation will provide a 50 percent match, up to $7,500, of money collected locally.
Her co-workers, Dagata-Grist said, are “making it so easy for everyone to just come and donate, it is amazing.”
Elizabeth Lynch can be reached at llynch@poughkeepsiejournal.com
Viragen’s Multiferon Approved for Sale in Chile
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PLANTATION, Fla., June 20, 2005 /PRNewswire-FirstCall/ — Viragen, Inc. and its majority-owned subsidiary, Viragen International, Inc. , today announced the approval of Multiferon(R), natural human alpha interferon, for sale in Chile. The Chilean regulatory authorities approved an application filed by Viragen’s distribution partner, Pentafarma S.A., which holds the exclusive rights to distribute the drug in Chile. Pentafarma is a wholly-owned subsidiary of Fresenius Medical Care.
“This is a compelling market opportunity for us, as a significant percentage of patients fail or cannot tolerate existing interferon regimens, and Multiferon(R) targets an unmet clinical need for those patients in Chile,” stated Pentafarma’s General Manager, Mr. Peter Endler. “We have placed an initial order to commence our sales program and distribute Multiferon(R) for all of its approved indications.”
Multiferon(R) is now approved in Chile for the second-line treatment of any and all diseases in which recombinant interferon therapy failed, possibly due to the formation of neutralizing antibodies. As an alternative to single- subtype, recombinant alpha interferons, Multiferon(R) is primarily marketed for the treatment of hepatitis B, hepatitis C, chronic myelogenous leukemia, hairy cell leukemia, renal cell carcinoma and malignant melanoma.
Viragen’s President and CEO, Mr. Charles A. Rice, stated, “We are pleased to announce achievement of yet another key milestone this year as we continue to meet our stated goals. As part of our South American strategy, Chile will be the first in this region to contribute to our sales growth, and with new approvals pending in other international markets, we are working towards building a global franchise to make Multiferon(R) the most widely prescribed natural human alpha interferon in the world.”
Headquartered in Santiago, Pentafarma S.A. is a specialized leader for the distribution of healthcare products related to dialysis, nephrology and other critical care drugs and is a wholly-owned subsidiary of Fresenius Medical Care, the world’s largest, integrated provider of products and services for chronic kidney failure.
About Viragen, Inc.:
Viragen researches, develops and commercializes pharmaceutical products designed to treat a broad range of viral and malignant diseases. These protein-based drugs include: Multiferon(R), a natural human alpha interferon, approved for sale in various international markets; and humanized anti-cancer monoclonal antibodies. Viragen is also pioneering the development of Avian Transgenic Technology, with the renowned Roslin Institute, as a biomanufacturing platform for the large-scale, efficient and economical production of therapeutic proteins.
For more information, please visit: http://www.Viragen.com
Viragen, Inc. Corporate Contact:
Douglas Calder, Director of Communications
Phone: (954) 233-8746; Fax: (954) 233-1414
E-mail:
dcalder@viragen.com
The foregoing press announcement contains forward-looking statements that can be identified by such terminology such as “expect,” “potential,” “suggests,” “may,” “should,” “could” or similar expressions. Such forward- looking statements involve known and unknown risks, uncertainties and other factors that may cause the actual results to be materially different from any future results, performance or achievements expressed or implied by such statements. In particular, management’s expectations regarding future research, development and/or commercial results could be affected by, among other things, uncertainties relating to clinical trials and product development; availability of future financing; unexpected regulatory delays or government regulation generally; the Company’s ability to obtain or maintain patent and other proprietary intellectual property protection; and competition in general. Forward-looking statements speak only as to the date they are made. The Company does not undertake to update forward-looking statements to reflect circumstances or events that occur after the date the forward-looking statements are made.
CONTACT: Douglas Calder, Director of Communications, Viragen, Inc.,+1-954-233-8746, or fax, +1-954-233-1414, or dcalder@viragen.com
Web site: http://www.viragen.com/
Ticker Symbol: (AMEX:VRA),(NASDAQ-OTCBB:VGNI)
Pills for The Poor
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Pills for The Poor
By Sebastian Mallaby
Monday, June 20, 2005; Page A15
Little by little, the world is coming around to two self-evidently good proposals to improve global health. But there’s a third, equally great proposal to which nobody pays attention. The contrast shows how corporate preferences, including largely irrational corporate preferences, distort policy toward the poor world.
Oddly, the two proposals with momentum are the ones that cost a lot. The first is designed to stimulate production of vaccines for diseases such as polio, yellow fever and hepatitis B. These vaccines have been around for decades, but poor countries can’t afford them, so most manufacturers have quit. When aid people scraped together money for vaccines in the 1990s, they had trouble finding willing suppliers.
The solution has been to create a dependable source of demand for these vaccines: to simulate the “pull mechanism” created by consumers in the rich world. By pouring $1.5 billion into a vaccine purchase fund and persuading rich governments to kick in a bit, the Bill and Melinda Gates Foundation has created an incentive for manufacturers to re-enter this business. (Full disclosure: Melinda Gates is on the board of The Washington Post Co.) Next month’s Group of Eight summit may boost this purchase fund’s prospects further. The British government is pushing an idea to enlarge it with money borrowed on the capital markets that will be repaid with future aid flows.
The second proposal is about drugs that don’t exist yet — for example, a malaria vaccine. Again, there’s no commercial incentive to invent these, since consumers in poor countries can’t afford to pay much. Practically all of the world’s drug development spending is targeted at the medical concerns of rich people. Hence the depressing fact that, of the 1,233 drugs licensed worldwide between 1975 and 1997, only 13 were for tropical diseases.
To fix this problem, the Gates Foundation has put its muscle behind an idea from Harvard’s Michael Kremer of Harvard University and Rachel Glennerster of Massachusetts Institute of Technology: Rich countries should make an advance commitment to spend, say, $3 billion on 200 million doses of a malaria vaccine if one is invented. This commitment solves the incentive problem and could be structured as a binding contract. The Gates people, working through the Center for Global Development in Washington, have brought in a law firm to draft appropriate language. Again, this idea has political momentum. Next month’s G-8 summit may get behind the Kremer-Glennerster idea.
So there’s an appetite to spend taxpayers’ money on buying existing vaccines and on a “pull mechanism” for new ones. But there’s a third challenge in this medical battlefield: How to make drugs that have been invented for rich countries available in the poor world. Contrary to popular myth, diseases such as cancer and heart disease are big killers in developing countries; in India, heart disease causes more than a quarter of all deaths. And yet, although pills for heart disease are swallowed by millions of Americans daily, these drugs are out of reach of the world’s poor.
About four years ago, when the Kremer-Glennerster purchase-commitment idea was germinating, Berkeley’s Jean Lanjouw advanced a solution to the heart-pill problem. The idea would cost nothing: It merely involves drug companies giving up patent protection for heart pills and similar medicines in the poor world. Since poor countries buy almost none of these medicines anyway, giving up patent rights in those markets doesn’t hurt the drug firms. But it would mean that cheap generic versions of these medicines could be distributed to poor consumers.
As well as costing nothing, the Lanjouw proposal would be simple to implement. It would require no multilateral negotiation, since it could be done with a modest fix to U.S. patent law. The fix would say that, as a condition of receiving patent protection in the U.S. market, the inventor of a drug must renounce patent rights in countries with a per capita income of less than, say, $1,000 per year.
Who could possibly object to this? The drug companies apparently fear that, if Indians are allowed to get cheap heart pills, these would find their way back onto the U.S. market. But the drug companies already accept the principle that AIDS drugs should cost less in Botswana than in Boston — and there aren’t too many reports of contraband African AIDS medicines flooding the U.S. market. Indeed, for all the fuss about seniors getting cheap drugs from Canada, these purchases represent a fraction of the U.S. drug market. Does anyone really think that Americans are going to buy masses of medicine from distant and possibly unsafe suppliers based in Mombassa or Mumbai?
Of course not. But four years after its appearance created a small flurry of excitement, the Lanjouw proposal has been forgotten. The reason is that, irrationally, drug companies want to close down all ideas involving weaker intellectual property rights, even if the rights they would forgo have no business value. The Gates Foundation, whose money derives from Microsoft’s intellectual property, has no interest in challenging this world view. Hence the perverse outcome: An idea that costs nothing has less traction than two ideas that cost billions.
Pic Of The Day
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Ohrid Lake : Two people in a small boat watching the sunset on Ohrid Lake in southwestern Macedonia.
BIO gathering to showcase, celebrate biotech creativity / Bay Area to have major presence in Philadelphia
Posted by rob on June 20, 2005 under Uncategorized | Be the First to Comment
- Bernadette Tansey, Chronicle Staff Writer
Sunday, June 19, 2005
Biotechnology’s largest annual conference has a few things in common with the yearly Burning Man gathering, though the comparison might outrage some devotees of the renegade wilderness art-fest born in San Francisco.
Granted, the 18,000 biotech industry folks converging at BIO 2005 in Philadelphia today will be mingling in tony hotel suites and posh museum halls rather than suffering the privations of the Nevada desert.
But like Burning Man, the Biotechnology Industry Organization conference also beckons thousands of people to form an instant city that celebrates creativity — in this case, the cutting edge of the biological arts.
Biotechnology also shares the art world’s reputation for pushing the envelope of societal boundaries. With its explorations of cloning and gene swapping among species, biotech literally challenges what it means to be human.
Bay Area companies will be a major contingent at the four-day international gathering at the Pennsylvania Convention Center, where participants can ponder the ethics of stem cell research, check out each other’s scientific progress and soak up the advice of experts in finance, law and drug development.
Up and coming firms like Exelixis Inc. of South San Francisco flock to BIO for a moment in the spotlight, where they can showcase their work to dozens of investment firms that might provide funding, or they can meet with other biopharmaceutical companies that might make good partners as they develop their products.
“It’s a good chance for us to have maximum exposure and visibility,” said Michael Morrissey, senior vice president of discovery at Exelixis.
Morrissey will speak at a panel on one of the hottest topics at BIO 2005 — the future of biotech drugs like Genentech Inc.’s Avastin that are targeted to interfere with specific molecular mechanisms involved in cancer. Exelixis has a stable of early-stage targeted therapies.
Like Burning Man, most BIO gatherings don’t lack for a contingent of fantastically costumed participants, but they’re usually part of the crowd of demonstrators dressed like mutants or giant ears of corn who muster outside the exhibit halls to protest bioengineered crops and biodefense policy.
Philadelphia activists are holding a BioDemocracy 2005 Counter-Convention in downtown Philadelphia near the biotech conference with the help of a Bay Area group called Reclaim the Commons, which formed last year to oppose BIO’s 2004 convention in San Francisco.
While San Francisco is considered the cradle of biotechnology as a commercial venture, this year’s BIO gathering is being held in the heart of the traditional U.S. pharmaceutical industry.
BIO 2005 is hosted by Pennsylvania, New Jersey and Delaware — a tristate region where huge companies like Johnson & Johnson and Merck & Co. are headquartered.
The sponsor states are eager to update the region’s image as a biotech cluster that has developed the same elements that made the Bay Area an international leader in the field, said Jeff Libson, a member of the Greater Philadelphia Venture Group, a private equity association.
The area boasts prestigious academic institutions like the University of Pennsylvania, its own cadre of venture capital firms and companies ranging from small biotech startups to big drug firms doing biotech research, Libson said.
“It has all the necessary ingredients,” he said.
The BIO conference, first held in 1993 for 1,400 participants, saw its attendance balloon in 2000 as the sequencing of the human genome created hope that knowledge of the DNA code would deliver rapid advances in disease treatment.
But while gene-based research methods of biotechnology have yielded enormous advances in basic knowledge about all types of cancer, said Morrissey of Exelixis, expectations for quick medical progress have become more realistic.
The success of biotech cancer drugs Avastin and Gleevec is founded in scientific discoveries made in the 1980s, Morrissey said. “Progress is made in incremental steps.”
Jeff Peterson, chief executive officer of 6-year-old Palo Alto biotech firm Target Discovery, plans to share tips at a BIO panel for early-stage companies trying to maintain a stream of funding during the often lengthy period when they try to translate scientific insights into marketable products.
Peterson’s firm, supported so far by angel investors, is trying to provide a scientific shortcut for drug development. Target Discovery looks for specific proteins that could help diagnosticians identify what disease a patient has and what drug would work best for him.
Ted Sweeney, the West Coast principal in a new consulting unit of the big pharmaceutical data firm IMS Health, will offer advice for small biotech firms that are looking for larger partners to help them commercialize promising drug candidates.
Sweeney said the time is ripe to strike favorable deals. Big drug firms will see patents expire by 2009 on products that bring in tens of billions of dollars, so they look to biotech’s innovative compounds to fill their drug pipelines, he said.
Small firms can use BIO’s Business Forum to meet potential partners. “BIO has kind of a dating service for companies,” Sweeney said.
This year’s BIO sets a record for attendance by participants from foreign countries, with more than 6,000 coming from 61 nations. Dr. Philippe Pouletty, president of France Biotech, said the companies represented by his trade association will be scouting for investors and company alliances.
Pouletty said the industry pulled out of its slump of 2001 and 2002, but he points to significant challenges like drug pricing pressures and a rising threshold of proof for Food and Drug Administration approval.
BIO is the place “to get a good feeling of what some of the hot trends are and see what your competitors are doing,” he said.
E-mail Bernadette Tansey at btansey@sfchronicle.com.
Pic Of The Day
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Children fish at the Ohrid Lake, on a hot pre-summer afternoon.
Photo Of Cracked Gleevec Tablet
Posted by rob on June 19, 2005 under Uncategorized | Be the First to Comment
Pill Poppers
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Next time you’re watching TV and feel that sudden urge to “ask your doctor” about your cholesterol level or heartburn, you may want to ask more than simply, “Is the advertised drug ‘right for me?’” Is the expensive pill you want, aside from its pretty color, any different than the one you are already taking? More importantly, does your doctor accept lunch, cash or other freebies from drug companies?
While you’re at it, ask yourself this question: Do you need the drugs, or do the drugs need you?
St. George physician Catherine Bonomo, 46, tries to get her patients, and other doctors, to ask those questions every day. Mostly she finds it’s like hitting her head against a wall.
“You see a commercial on TV 75 times and these nice people on television are telling you this is the medicine you need. They are happy people, floating around. Their lives are good. That is already ingrained in your memory bank. You go to visit the doctor. He makes an attempt to explain to you why this medicine may not be the one for you, but you’ve already been conditioned,” Bonomo says.
It’s an increasingly common predicament for doctors: patients showing up pre-diagnosed by advertising and demanding a drug by brand name. Try suggesting a different drug, or be even bolder—like Bonomo—and tell the patient they don’t need the drug at all, that drug companies may be no different from other salesmen, and you’ll get an earful.
“A few [patients] are receptive, but most of them aren’t,” says Bonomo. “They get frustrated. ‘But it was on TV, so it must be true.’”
Bonomo doesn’t give in. “I make a few people unhappy, but I think medicine is one of those fields that you have to maintain some integrity and some intellectual honesty about what you’re doing. There are business aspects about medicine, but I would hope that most physicians would remember that it’s a little bit more than that.”
Bonomo is hyperaware of the impact of drug-company marketing on patients and the doctors who serve them. She is the only physician in the state of Utah to have sworn off the drug companies—at least officially. Bonomo said drug companies are not all bad: “They peddle some good drugs,” she says. What she doesn’t want is for her medical decisions to be influenced by advertising.
Her quarters at the emergency department of Dixie Regional Medical Center are remarkable for being devoid of pens and calendars bearing logos of pharmaceutical manufacturers. She gets quizzical looks from fellow doctors and patients for the “No Free Lunch” button she wears on her scrubs every day to work. It’s the moniker of a growing movement of physicians who say they can’t be bought off by drug-company giveaways. The same sort of giveaways—free lunches, golfing junkets, cash “consulting fees,” or, a past drug-company favorite, ski vacations to Utah—that were once the staples of U.S. congressmen until public outrage put a stop to them.
For all the money drug companies spend advertising new or improved products—around $4 billion last year—it’s just a tiny portion of the amount drug companies spend to sell their wares in other ways. The total marketing budget of U.S. pharmaceutical companies—everything from ads, to sponsoring medical conferences to buying lunch for doctors—topped $22 billion in 2003, according to IMS Health, a company that tracks drug sales for its drug-industry clients. The vast majority of that $22 billion went to directly influence doctors, primarily through $16 billion worth of free drug samples delivered to physicians’ offices by an army of drug reps bearing lunch.
Doctors are routinely paid “consulting” fees to listen to drug-company talks at resorts. And drug companies are significant sponsors of lectures at medical schools and conferences where doctors sit through required continuing medical education courses. In Utah, Bonomo isn’t altogether alone in fighting such tactics. At the University of Utah School of Medicine, American Medical Student Association co-president Nick Warner says he is having little luck trying to get fellow students to “just say no” to the drug reps who routinely take third- and fourth-year students to lunch.
What Drug Companies Feed On
In a recent book, Dr. Marcia Angell, a former editor of The New England Journal of Medicine, takes issue with the long-touted pharmaceutical-industry assertion that drug prices are high because pharmaceutical companies invest so much in researching new cures for the world’s diseases. Angell claims drug-company marketing budgets now far outstrip the amount spent on research and development. By her estimate, twice as much is spent selling drugs as researching them.
“The drug companies have done very little recently that’s new,” Angell said from her home in Cambridge, Mass., pointing out that cholesterol-lowering Lipitor, the best-selling drug in the world, is patterned after a drug that came on the market in the mid-1980s. “In most cases the basic research is publicly funded, done mainly in universities with [National Institutes of Health] funding. … That’s what they feed on.”
Angell, author of The Truth About the Drug Companies, claims what research drug companies do is devoted to creating their own versions of drugs already invented by others, resulting in an assembly-line stream of pills barely better than generic versions available for years.
Pharmaceutical companies have essentially turned into marketing machines, she says, concerned mostly with promoting diseases to fit the drugs they make. Developing a cure for a previously incurable disease is much less profitable than, for example, making a slight change to the makeup of an existing drug, patenting it, coloring the resulting pill purple and selling it as something new and expensive, as happened with Nexium, the “Purple Pill,” which is chemically similar to AstraZeneca’s earlier acid-reducing drug.
Instead of research, Angell claims the pharmaceutical industry spends most of its time making up scary names for common ailments to sell drugs of little value to a wealthy population. Meanwhile, the industry largely eschews research on diseases such as malaria that kill thousands of the poor.
It’s the market at work, Angell says. “There are more healthy people in the country than there are sick people, so if you want a really big market what you are going to do is push drugs to essentially healthy people,” she said. “If you look at direct-to-consumer advertising, you see that much of it is promoting a medical condition, not a drug, so that people will think that they need drugs when they may not need them.”
She blames drug-company ads for duping many into believing they have “dubious or exaggerated ailments” such as “generalized anxiety disorder”—otherwise known as shyness, “premenstrual dysphoric disorder”—aka PMS, or “gastro esophageal reflux disease”—aka GERD.
Today, thousands of Americans have prescriptions for Nexium—the fourth-best-selling drug in the country—or similar prescription drugs developed to treat the serious problems of stomach acid eating the esophagus. Many, Angell alleges, just have heartburn.
“The implication in the direct-to-consumer ads is if you have heartburn you’re well on your way to cancer of the esophagus,” Angell said with a sarcastic laugh. “It’s playing into a drug-intensive style of medicine that teaches for every ailment or discontent there is a pill. For most people who have heartburn, the best way to treat it is probably to lose a little weight, get out and take a walk or drink a glass of milk, but that somehow is seen as less good than taking a prescription drug.”
An ongoing class-action lawsuit alleges AstraZeneca duped the nation by heavily marketing Nexium just as its old version of the drug was losing patent protection, opening it up for competition from generics.
Drugmaker Eli Lilly took a similar tack when it got approval from the Food and Drug Administration to market the antidepressant Prozac for severe premenstrual syndrome. It colored the drug pink and sold it as Sarafem, a “new” drug that costs several times the now-generic Prozac. The condition the drug is supposed to treat has never been recognized by the American Psychiatric Association, but the APA is now considering adding “premenstrual dysphoric disorder” to its manual of mental problems based on the FDA approving a drug for it.
Of 78 drugs approved by the FDA in 2002, only 17 were new chemical compounds, Angell claims. None of the new drugs put out by U.S. drug companies that year were classified by the FDA as likely improvements over drugs already on the market. And, she notes, drug companies are taking more in profits than any other industry, a 17 percent average profit rake for the top 10 American drug companies in 2002, compared to 3 percent average profits for other Fortune 500 companies.
The No Free Lunch Bunch
Bonomo says most of her professional colleagues deny that drug-company gifts—a slice of pizza or a few logo-emblazoned pens—influence their prescribing habits. However, she knows the impact is real because she sees new drugs in circulation at the hospital where she works every time the drug reps pay a visit. Too often, Bonomo said, a drug rep arriving with lunch from the Olive Garden substitutes for careful review of the medical journals when it comes time to decide which drugs to buy.
Her outlook on drug-company marketing differs because she didn’t enter the medical profession believing perks and constant advertising came with the job.
In her mid-40s, Bonomo has been a doctor just four years. She never thought about entering medical school until after her two children were raised and she was divorced. Then, “I decided if my life is going to change, it ought to really change,” said Bonomo, a former ambulance driver.
Bonomo entered the University of Utah School of Medicine at age 33. She served her medical residency in Los Angeles under a doctor who was a member of No Free Lunch, a New York organization enlisting physicians nationwide with the pledge to “accept no money, gifts or hospitality from the pharmaceutical industry” and “seek unbiased sources of information” apart from drug-company marketers about which drugs are best for their patients.
Bonomo later signed up with No Free Lunch herself because she is convinced the ties between the pharmaceutical industry and the medical establishment are now so tight that many doctors can’t tell the difference. The result, Bonomo believes, is that some ineffective, possibly dangerous, treatments have become standard despite scientific evidence against them.
Her prime example is the promotion of a blood-clot-busting drug as something of a miracle cure for stroke. The treatment became standard in 2000 when the American Heart Association (AHA) trumpeted that the drug “saved lives” in stroke victims—a claim withdrawn when it came to light the drug’s maker, Genentech, had built the heart association a new conference center.
The AHA’s green light came despite several studies showing that, unless given very carefully, stroke patients given the drug were up to three times as likely to die as patients given a placebo.
Still, ask any doctor today, and nine out of 10 will tell you to administer the drug within three hours of a stroke, Bonomo says.
“The scientific evidence out there does not support this; in fact, it says just the opposite,” said Bonomo, her voice rising. “But this was pushed and marketed so heavily by the pharmaceutical companies that it has been entrenched into the thought processes of many physicians.”
Eight of nine AHA experts who wrote the stroke guidelines had financial ties to the drugmaker. That is not uncommon. In a 2002 review, The Journal of the American Medical Association found 60 percent of doctors defending a drug’s use had relationships with the drug’s makers. Drug companies provide a significant portion of the budget for the FDA. One-third of the experts who recently recommended putting Vioxx and other arthritis medications recalled for increasing the risk of heart attack back on the market worked as consultants to makers of the drugs, according to the Center for Science in the Public Interest.
Vioxx is just the most prominent example of alleged bad behavior by drug companies. Patients and lawyers are lining up in huge class-action lawsuits against the makers of some of the most popular medications. Allegations range from hiding information about dangerous side effects, to price-fixing, to paying other drug companies not to market generic versions, to cornering the market on a drug’s active ingredient, then hiking prices.
In April, Mark Shurtleff, Utah’s attorney general, announced settlements in two lawsuits against drugmakers. In one, Pfizer subsidiary Warner-Lambert paid Utah $1 million to settle Medicaid fraud allegations Shurtleff said demonstrated “the company was more concerned about profits than the health of its customers.”
The company was charged with illegally promoting its epilepsy drug Neurontin for a long list of unapproved conditions, including bipolar disorder for which the drug was found to have no effect. Allegations included paying doctors illegal kickbacks to promote the “off-label” uses, lying about the drug’s safety in medical literature and illegally billing Medicaid. The 50-state $430 million settlement paled in comparison to the drug’s $2.7 billion in sales for 2003, 90 percent of which came through “off-label” prescriptions.
Among the biggest lawsuits are giant class-action cases against the makers of antidepressants linked to suicide in young people and arthritis drugs, like Vioxx, found to promote heart attacks. Scares over some arthritis drugs were exacerbated by revelations that drug companies knew of problems, but hadn’t made findings public.
Among the most startling aspects of Vioxx to anyone who has seen television commercials for the drug is that while it is one of the best-selling medications for arthritis—$1.3 billion in 2004—it has never been proven any better than aspirin at relieving pain. The drug’s maker never claimed it was—at least not in the medical literature—where its benefit was given as a lower incidence of ulcers.
It’s one of the drugs Angell argues is more marketing than drug. “For most Americans, and certainly for Americans who have good insurance, we’re overmedicated,” she says. And in many cases “we’re taking drugs that have never been shown to be more effective or safer than older, cheaper drugs.”
Among the “ask your doctor” television ads running in recent months, one tells viewers that although they may think they have their cholesterol under control, they should think again. That’s because the definition of high cholesterol was changed last year. Eight of nine experts who sat on the government National Cholesterol Education Program panel that recommended the new guidelines had financial ties to companies marketing cholesterol-lowering drugs, according to the Center for Science in the Public Interest. In a letter of complaint, the Center noted no studies had proven that increasing use of such drugs helped elderly men likely to take them, but the drugs were known to increase the risk of cancer.
Angell claims the big drug companies control not only the drug-approval panels, but, with heavy political contributions, call all the shots in Congress. Last year, Congress passed a law creating a new drug benefit for Medicare. The industry successfully lobbied for a line in the legislation specifically barring the nation’s Department of Health and Human Services—now headed by former Utah Gov. Mike Leavitt—from negotiating lower drug prices. The administration argues the free market will provide lower prices than a government monopoly.
Tommy Thompson, Leavitt’s predecessor in the HHS job, loudly grumbled about the negotiation ban, but Leavitt—to whom the drug-company lobby gave $9,500 over his last two Utah gubernatorial races—hasn’t argued against the policy. The new federal coverage for seniors’ drugs is projected to increase drug-company profits by 38 percent over its first eight years.
Ethics and Erectile Dysfunction
The shock troops in the drug companies’ selling efforts are the “detail men” who descend daily on hospitals, medical schools and doctors’ offices.
“They’ll come in with pizzas. I’ve seen them come in with shaved ice machines, doughnuts, sometimes meals, drop them off in the back, say, ‘Hi,’ smile a lot. They look nice,” Bonomo said, her measured doctor voice giving way to her more usual folksy speech pattern. “They will drop off food, but they also will drop off pens, napkins or calendars, something so their name is seen over and over and over and over again.”
Under pressure from doctors like Bonomo, the drug companies’ lobbying association, the Pharmaceutical Research and Manufacturers of America (PhRMA), came up with a new code of ethics in 2002 instructing member companies in the ways of influencing doctors. Under the rules, giving doctors cash for writing prescriptions is bad—not to mention illegal. Paying doctors a handsome “consulting” fee to come to a resort golf course for training as company “speakers,” however, is just fine.
So, while pharmaceutical companies cannot bribe docs directly, they can form alliances with them in plenty of other ways, just as political lobbyists often form alliances with elected officials. One maker of a popular erectile-dysfunction drug paid doctors cash after they wrote prescriptions. Ostensibly the money was to compensate doctors for time spent enrolling the newly prescribed patients in a study.
The practice is perfectly acceptable under PhRMA’s ethical guidelines and there is no formal regulation. The rules are purely voluntary.
The American College of Physicians also has a new ethics manual strongly discouraging doctors from accepting “gifts, hospitality, trips and subsidies of all types.” But that didn’t stop the ACP from financing its annual meeting, in April, largely through the drug industry. Drug companies were inspired to fork over money to sponsor $60,000 in tote bags after ACP’s promise that the annual meeting “offers an unparalleled opportunity to meet with physicians of power—prescribing power.” No Free Lunch asked to exhibit but was turned down.
PhRMA spokesman Jeff Trewhitt notes that a large portion of drug-company-marketing spending goes for free samples that give doctors “early hands-on experience with a new medicine” and often are the only source of medication for the poor.
But the more drug companies advertise products, the worse the public’s view of the industry, polls show. PhRMA now recognizes that the brand as a whole needs promotion. As the industry struggles not to become the next “big tobacco” in the mind of the public, PhRMA is getting ready to counter what Trewhitt calls a “barrage of distorted allegations.” If you thought the television was filled with drug ads before, get ready for a blitz.
Trewhitt said PhRMA will be “talking about the innovation of the industry” and advertising its efforts to get drugs into the hands of the one-fourth of Americans who don’t have drug coverage. A new wave of drug-industry commercials already has aired touting drug-giveaway programs for the indigent, to whom PhRMA member companies provided about 40 million free prescriptions during the past two years.
The ads may be just in time. Bonomo is the only No Free Lunch member in Utah, but following last year’s scandals of allegedly dangerous—but widely advertised—drugs being pulled off the market, there is a growing wave of suspicion of the pharmaceutical companies.
In Salt Lake City, family doctor Ross Brunetti hasn’t officially sworn off the drug companies, but he has taken an increasingly common position of limiting his interactions with their reps, whom he refers to as “overdressed used-car salesmen.”
He says he doesn’t have a choice. The number of drug reps plying their wares doubled in the late 1990s reaching the point where, today, there is more than one drug rep for every five office physicians. If Brunetti visited with every rep who dropped by his office, that would be all he could do. He estimates that six reps drop by his office every morning, followed by six more in the afternoon.
“In a week, I might see three people trying to sell me the same thing,” he said. “On Friday, when they want to get out early and go skiing, they’re all here, all in the morning. There are more drug reps than patients. It’s like a minefield.”
Brunetti is offended by the sheer amount of money spent peddling drugs, which he believes drives up costs, but he also thinks constant meetings with drug salespeople are a serious liability issue for doctors. “The biggest cause of medical malpractice is interruptions. That’s their job, to interrupt me. I don’t let ’em. I let ’em stand there ’til I’m good and done with a patient,” he said.
“As far as we’re concerned [drug reps] are lying when their lips are moving,” he said. “We tolerate them only because they leave [drug] samples for people who can’t pay.”
The charity drug programs PhRMA is touting in new ads provide a large portion of the prescriptions issued through the Salt Lake Community Health Centers. David Keahey, a physicians assistant who regularly volunteers at the Central City clinic, appreciates the programs, but says the drug companies aren’t giving it away strictly out of the goodness of their hearts.
The drug companies “have donated a lot of stuff over the years,” he said. “There is another issue. The drug companies, in my opinion, do this not only out of a sense of altruism … but to keep the status quo. They can say, ‘Well, we’re taking care of the problem, we have these programs so we’re doing our part.’”
Twenty years ago, when Keahey began volunteering, drug companies helped by dropping off large numbers of samples. Now, the samples largely have been replaced by charity programs and accompanying large amounts of red tape with which not all low-income clinics can cope.
Keahey’s clinic has resorted to hiring employees who do nothing but fill out drug-company forms. Keahey can’t see much reason for the constant form filling, but noted “anytime you put requirements of paperwork and bureaucracy between patients and service you’re going to reduce utilization.”
Angell remains one of the biggest thorns in the side of the industry. PhRMA’s Website prominently featured a lengthy rebuttal to her book, particularly her claim that drug companies skimp on research spending in favor of marketing and profit.
The drug industry argues with Angell’s numbers, saying she incorrectly lumps administrative costs with marketing when she compares advertising to research spending. Angell shoots back that most drug companies report the costs together, “which obfuscates how much they spend on both.” PhRMA’s numbers, she claims, leave out billions spent on so-called “education” of doctors through sponsorship of medical conferences and meetings of professional societies.
The industry’s own numbers show marketing making up a huge portion of spending, $21 billion in 2003 compared to $33 billion spent on research and development.
PhRMA also looks to different statistics to refute Angell’s allegation that drug companies sponge off government research. Trewhitt points to a 2001 study by Congress that found nearly all top-selling drugs that year were developed without help from the government. Angell says that’s a misreading of the report that found four drugs were certainly developed without government help but couldn’t make a determination for many others because of missing records.
Trewhitt acknowledges the nation faces a drug “crisis,” but paints the problem as one of lack of insurance coverage to pay for drugs.
The drug companies argue it’s a whole new world. Spending on drugs is increasing because drugs are now available to treat and prevent conditions that used to land people in the hospital. Under this analysis, the growing chunk of the health-care pie that goes for cholesterol drugs, for example, is made up for by savings on heart surgeries. Bottom line: Everyone may be on something, but we’ll all be healthier for it.
Indeed, more Americans are medicated than ever before. In the past decade the number of prescriptions ingested by Americans has jumped by two-thirds, according to IMS Health. Americans lead the world in per-person drug purchases, spending 18 percent more than France, the next leading drug-consumer, according to the Organization for Economic Cooperation and Development. Sales have increased at an average rate of 11 percent per year during the past five years. A significant increase also has been recorded in bad drug reactions reported to the FDA, which went up more than 200 percent during the past decade.
To criticism that U.S. drug companies aren’t inventing many new drugs, Trewhitt acknowledges “it would appear” to be the case, but adds that’s a temporary phenomenon. Inventing drugs is a lot harder than it used to be, Trewhitt said. Drug companies are geared to solve medical problems with chemicals, but today’s unsolved conditions, such as Alzheimer’s, must be cured through still-developing biotechnology. “This is a steep learning process for many companies as they make the transition,” he said.
While pharmaceutical companies remain among the most profitable in the nation, it’s getting harder to make a buck as competition heats up and health plans lean on patients to use low-cost generic drugs, notes IMS Health.
“A single point of market share can mean tens of millions of dollars of profitability,” states the Website of IMS Health, which keeps detailed lists of doctors’ prescribing habits to help drugmakers identify “key prescribers driving brand performance.”
“Now, more than ever, brand managers are facing increased pressure to achieve aggressive revenue targets with tighter budgets,” the Website notes. “Marketers must optimize brand performance … focusing on reaching every stakeholder, from physicians to consumers.”
The Website might just as well have added “reaching politicians,” another target of pharmaceutical company largesse.
As the political debate over drug costs heats up, drug companies are making sure politicians know where their bread is buttered. In Washington, D.C., Utah Sen. Orrin Hatch is ferried to speeches in drug-company jets. In Utah, the State Health Department is encountering resistance to its idea for controlling Medicaid spending by promoting generic drug use. The department estimated a generic shift could help save $12 million per year, but some legislators balked, citing states that have tried similar tactics only to lose money on new bureaucracy. Drugmakers gave Utah lawmakers more than $56,000 for last year’s elections.
Increasingly, industry critics see little difference between such campaign contributions and the freebies and cash provided to doctors.
What the typical patient doesn’t know, Bonomo says, is that the typical physician doesn’t know a whole lot about drugs. Reading scientific studies isn’t in the standard course for doctors. While there are widely available sources of information on drugs not written by the drug companies, reading the literature dropped off by the drug reps, along with a pizza, is much easier.
Sporting her “No Free Lunch” badge, Bonomo often gets looked at like she’s a crazy person. She sometimes feels like a lone prophet in the wilderness decrying the false God raining doughnuts and drug samples from the sky.
Often, she’ll walk in on a group of doctors surrounding a pizza dropped off by a drug rep and chide them, “You’re selling your soul to the devil. You guys are eating the drug food again. Haven’t you been listening to me?”
Sometimes, when she hasn’t eaten for 10 hours, that slice of pizza looks good. But “No Free Lunch” Bonomo keeps her fast.
Columbia University Launches Multi-Year Campaign to Support Stem Cell Research
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Columbia University Medical Center (CUMC) announced today that it is halfway toward realizing the first phase of a multi-year campaign to build upon the university’s groundbreaking stem cell research and lead the effort to fully realize the therapeutic potential of stem cells. Of the $50 million goal for the first stage of the campaign, $25 million has been raised from the private sector, specifically for diabetes and neural stem cell research.
Columbia University Medical Center researchers are at the forefront of an extraordinary movement to revolutionize medical approaches to therapeutics through its Stem Cell Initiative. Columbia’s leadership in developmental biology, neuroscience research, transplantation, and cell replacement therapy uniquely positions the university to push stem cell research forward, and more than 40 CUMC researchers are currently conducting leading stem cell studies.
“This initiative will provide our researchers with the resources necessary to fully realize the potential of stem cells,” said Gerald D. Fischbach, M.D., executive vice president of Columbia University Medical Center and dean of the faculty of medicine at Columbia’s College of Physicians and Surgeons. “Columbia continues to be a leader in this revolutionary health technology that holds the promise to benefit people suffering from a wide variety of debilitating health problems.”
Federal restrictions on human embryonic stem cell research funding and lagging state funds have limited available government support for this emerging and promising research, prompting CUMC to reach out to the private sector with this crucial stem cell initiative.
CUMC researchers are currently exploring the vast potential of stem cells to treat a wide range of illnesses, including Parkinson’s disease, amyotrophic lateral sclerosis (ALS), diabetes, pancreatic cancer, leukemia, stroke and other diseases of the nervous system, liver, eye, skin, and heart. Beyond replacement therapy, the use of stem cells as a research tool will lead to new insights regarding mechanisms that control the onset and progression of disease. Stem cells will also be useful as targets in drug discovery. Current stem cell research projects at CUMC include:
– Examining the development, function and survival of dopamine neurons, which are lost in patients with Parkinson’s disease, focusing on developing replacement cells or a model for investigation of genetic forms of the disease
– Developing an experimental procedure that expands the use of umbilical cord blood in transplantation for childhood leukemia and solid tumor patients
– Implanting stem cells that turn into insulin-producing cells to fight the growing epidemic of diabetes
– Studying the biology of stem cells that produce new neurons in the normal adult mammalian brain as a key to understanding brain repair and neural pathologies.
– Generating specific spinal and brain nerve cells from embryonic stem cells
– Developing potential new cancer remedies
“In the last several years scientists have managed to unlock many of the secrets behind stem cells and their remarkable ability to develop into different kinds of cells, but there is still much to learn,” said Asa Abeliovich, M.D., Ph.D., whose research is focused on developing stem cells to replace dopamine neurons lost in Parkinson’s disease or models to mimic the degeneration process. “The resources provided by Columbia’s stem cell initiative will help us answer those questions and translate this research into practical applications for many our most devastating diseases.”
The initial $50 million for the Columbia Stem Cell Initiative will enable Columbia to outfit a new stem cell center, construct a state-of-the-art facility to produce cells for experimental and therapeutic use, and establish a separate laboratory dedicated to growing new human embryonic stem cells for new studies. It will also support the recruitment and retention of internationally renowned stem cell biologists and establish endowments for professorships for Columbia’s stem cell physicians and scientists as well as scholarships for doctoral candidates and post-doctoral fellows focused on stem cell studies.
NOTE: Additional CUMC stem cell experts can be found at the Stem Cell Consortium website at www.healthsciences.columbia.edu/hs/stemcell
umbia University Medical Centervides international leadership in basic, pre-clinical and clinical research, medical education, and health care. The medical center trains future leaders in health care and includes the dedicated work of many physicians, scientists, nurses, dentists, and other health professionals at the College of Physicians & Surgeons, the School of Dental & Oral Surgery, the School of Nursing, the Mailman School of Public Health, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. With a strong history of some of the most important advances and discoveries in health care, its researchers are leading the development of novel therapies and advances to address a wide range of health conditions. http://www.cumc.columbia.edu
Columbia University Launches Multi-Year Campaign to Support Stem Cell Research
Pic Of The Day
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A man flies in an ultralight flies in front of two hot-air balloons during the King cup Balloon 2005 in Villanueva del Pardillo, near Madrid.
Our New CMLWireless Group Has Started
Posted by rob on June 18, 2005 under Uncategorized | Be the First to Comment
Nearly 2 billion people are now using wireless for email and text messages through cellphones, PDAs, and other wireless devices. Since there are a number of CML patients and caregivers who now have wireless devices we have started a new group CMLWireless that has been configured for short SMS type messages. This will provide a network for CML patients to communciate with each other when they are away from their primary computer and email account. Those who join the group will be able to send short text messages to CMLWireless@cmlhope.com which will be distributed to all of the group members in the same way that the Google and Yahoo groups work through delivery to their wireless device. The CMLWireless group will be low volume and is intended only for the more important types of messages so members will be able to contact others while they are on vacation or business travel, at work, in the hospital, or other locations. If you would like to join go to the CMLWireless web site and enter the email address of your wireless device (i.e. 2125551212@sprintpcs.com) and return the confirmation email that is sent. You can also join from a regular email address as well if you would like to communicate with others in the group, answer questons, etc. When you are subscribed please limit messages to 3, 4, 5 lines since most wireless devices such as cellphone cannot receive longer messages.
CMLWireless is the first group that we have set up on the CMLHope Groups mail system at http://groups.cmlhope.com The new sytem will allow in the future to create additional types of groups outside of the Yahoo or Google systems on our own servers. We may, for example, in the future create user groups for participents in the BMS, AMN, and other trials and other types of sub-groups. In the long run we will be able to do more on our own servers since we will be free from the harassment that has become so common on public hosting sites.
Pic Of The Day
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Grey and misty weather in Dublin failed to dampen the spirits of fans from Ireland and around the world joining in the festivities to celebrate James Joyce’s famed, fictitious ‘Bloomsday’
Review: tubulin function, action of antitubulin drugs, and new drug development.
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Pellegrini F, Budman DR
Cancer Invest. 2005; 23(3): 264-73
Anticancer agents that interfere with microtubulin function are in widespread use in man and have a broad spectrum of activity against both hematological malignancies and solid tumors. The mechanisms of actions of these agents have been better defined during the past decade, indicating that there are distinct binding sites for these agents and that they interfere with microtubulin dynamics (growth and shortening of tubules) at low concentrations and only evoke microtubulin aggregation or dissociation at high concentrations. Tubulin has been recently described in the nucleus of cells and in mitochondria. Downstream events from tubulin binding are believed to be critical events for the generation of apoptosis in the malignant cell. The effects of vinca alkaloids and taxanes are distinct, suggesting that the interference with the tubulin cap by high-affinity binding of effective agents is not the only mechanism of cytotoxic effect, and the low-affinity binding of drug, which distorts microtubulin function, may also be important. The epothilones share some of the binding characteristics of the taxanes and are in clinical trials because of cytoxic activity in taxane resistant cells. Tubulin has additional target sites for anticancer drugs including interference with the binding and function of microtubule associated proteins and interference with motor proteins which are essential for the transport of substances within the cell. Because many of these microtubule associated proteins have an ATP binding site, both computer-aided design and combinatorial chemistry techniques can be used to make agents to interfere with their function analogous to imatinib mesylate (Gleevec). Agents that interfere with the motor protein kinesin are entering clinical trials.
Review: tubulin function, action of antitubulin drugs, and new drug development.
A functional approach to questions about life, death, and phosphorylation.
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Bernards R
Cancer Cell. 2005 Jun ; 7(6): 503-4
The success of the family of kinases as targets for small-molecule cancer therapeutics is probably best illustrated by the efficacy of the drug Gleevec. In spite of this, the function of many of the kinases in the mammalian genome remains unknown. In a recent paper, MacKeigan and colleagues report a functional genetic screen using RNA interference to identify kinases and phosphatases involved in programmed cell death (). Functional annotation is a prerequisite for selection of new drug targets. Such studies may therefore lay the foundation for the next generation of cancer drugs.
A functional approach to questions about life, death, and phosphorylation.
Oncogenes as novel targets for cancer therapy (part I): growth factors and protein tyrosine kinases.
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Zhang Z, Li M, Rayburn ER, Hill DL, Zhang R, Wang H
Am J Pharmacogenomics. 2005; 5(3): 173-90
In the past 10 years, progress made in cancer biology, genetics, and biotechnology has led to a major transition in cancer drug design and development. There has been a change from an emphasis on non-specific, cytotoxic agents to specific, molecular-based therapeutics.Mechanism-based therapy is designed to act on cellular and molecular targets that are causally involved in the formation, growth, and progression of human cancers. These agents, which may have greater selectivity for cancer versus normal cells, and which may produce better anti-tumor efficacy and lower host toxicity, can be small molecules, natural or engineered peptides, proteins, antibodies, or synthetic nucleic acids (e.g. antisense oligonucleotides, ribozymes, and siRNAs). Novel targets are identified and validated by state-of-the-art approaches, including high-throughput screening, combinatorial chemistry, and gene expression arrays, which increase the speed and efficiency of drug discovery and development. Examples of oncogene-based, molecular therapeutics that show promising clinical activity include trastuzumab (Herceptin((R))), imatinib (Gleevec((R))), and gefitinib (Iressa((R))).However, the full potential of oncogenes as novel targets for cancer therapy has not been realized and many challenges remain, from the validation of novel targets, to the design of specific agents, to the evaluation of these agents in both preclinical and clinical settings. In maximizing the benefits of molecular therapeutics in monotherapy or combination therapy of cancer, it is necessary to have an understanding of the underlying molecular abnormalities and mechanisms involved.This is the first part of a four-part review in which we discuss progress made in the last decade as it relates to the discovery of novel oncogenes and signal transduction pathways, in the context of their potential as targets for cancer therapy. This part delineates the latest discoveries about the potential use of growth factors and protein tyrosine kinases as targets for therapy. Later parts focus on intermediate signaling pathways, transcription factors, and proteins involved in cell cycle, DNA damage, and apoptotic pathways.
Oncogenes as novel targets for cancer therapy (part I): growth factors and protein tyrosine kinases.