Double life? Experts are intrigued by Gleevec effect on some diabetics.
Is a diabetes treatment using targeted cancer drugs? This is a question asking two independent teams after giving leukemia patients Gleevec drug and watch their regression of pre-existing diabetes. A 70-year-old woman improved dramatically that she could be considered a type 2 diabetic, three physicians reported last week in the New England Journal of Medicine (NEJM) .
Gleevec was designed to disable a defect in a protein called tyrosine kinase that occurs in chronic myeloid leukemia (CML), a blood cancer. The connection with diabetes does not come as a complete surprise; Gleevec affect other kinases which indirectly contribute a control insulin signaling and the body's response to insulin secreted by the pancreas. And it strikes a known protein kinase growth factor, platelet derived which can stimulate conditions such as atherosclerosis, which are common complications of diabetes. Two mouse studies recently by Mark Cooper and colleagues from the Baker Heart Research Institute in Melbourne, Australia, showed that Gleevec helped animals with atherosclerosis induced by diabetes and kidney disease caused by diabetes .
The benefits may apply to humans, too. In November 04 Journal of Clinical Oncology , doctors from the University of Rome described seven patients with type 2 diabetes and CML. Six improved enough to reduce drugs against diabetes or insulin doses. The only patient whose diabetes did not help, the team said, was also the only one whose leukemia has not responded to Gleevec.
And now in NEJM , Enzo Bonora, an endocrinologist at the University of Verona, hematologist and two colleagues report improvements in three other cancer patients with diabetes, including older women. Italians can not tell if an effect on insulin signaling is behind the unusual observations. In addition, the cohort is tiny, Bonora stresses, so the results should be viewed with caution. "We do not know exactly what is happening," he said.
Neither do others. Brian Druker of Oregon Health & Science University in Portland, a hematologist-oncologist who helped develop Gleevec, said three or four diabetics with CML were treated at the center, and he does not remember changes in their diabetes while on the drug. Yet Druker said that the new findings are "hard to ignore."
Bonora considering asking Novartis, the Swiss company that makes Glivec to consider testing the type of medication 2 diabetes. Currently, Novartis " does not expect "the Gleevec study in type 2 diabetes, spokesperson for Novartis Kim Fox wrote in an email.
Related Sites
American diabetes Association
Information about Gleevec to the Food and Drug administration
Gleevec Context of the National cancer Institute
Clip NEJM letter
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