| Chemists created nilotinib with the idea
of improving the target specificity of an earlier kinase inhibitor,
imatinib. Studies show it is 20 to 50 times stronger than imatinib.
Nilotinib is also intended to be specific for BCR-ABL.
The manufacturer, Novartis, says Nilotinib
caused a hematologic response in 74% of cases in clinical
trials for use on Ph+ CML leukemia. CML makes up 15% of leukemia
cases in adults, and the Philadelphia chromosome (the Ph+ designation)
is present in most CML patients.
This agent also inhibits the receptor tyrosine kinases platelet-derived
growth factor receptor (PDGF-R) and c-kit, a receptor tyrosine
kinase mutated and constitutively activated in most gastrointestinal
stromal tumors (GISTs).
In October 2007, the FDA approved Nilotinib for CML. Specifically,
the medicine was approved for the chronic phase and accelerated
phase Philadelphia chromosome positive (Ph+) chronic
myelogenous leukemia. Doctors have the authority to prescribe
the medicine for other conditions, and it may happen that nilotinib
is combined with other medicines for treatment.
In June 2008 Italian doctors presented evidence of the efficacy
and tolerability of nilotinib in CLL. The complete cytogenic response
among patients in their tests was 84%.
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