CHEMOTHERAPY, that treatment that eliminates cancer cells along with normal cells, will someday be a thing of the past as science advances into the 21st century. The “sniper” drugs are here.
By focusing not on the organ but on the pathway from the gene to the cancer cells, “sniper” drugs are designed to hit their precise mark without affecting healthy cells and other organs. Selecting the pathway means the drug going directly where the cancer cells are, such as in the pancreas, lungs, breast, bile duct, said Dr. Gianluca Fincato, regional medical director for emerging growth markets of Novartis.

Fincato was among the specialist-speakers during the Novartis media event held recently at the Novartis Campus in Basel, Switzerland.

“Everything is regulated by the pathway. If we are able to inhibit or block those, we are closer to finding the final solution to [some] cancers. There is a trigger, a reason, a mechanism underlying a disease. We are trying to understand why the tumor is there—the real cause of the disease,” Fincato said in an interview with Inquirer.

Complicated area

Although Fincato is quick to say that oncology is a very complicated therapeutic area where solutions are certainly not devised overnight, there is reason to be optimistic about the recent developments.

Take, for instance, Novartis’ evolution on treatment of Ph+ Chronic Myeloid Leukemia (CML). Twenty years ago, in 1990, said Fincato, a drug was proven 30-percent effective in delaying and reducing the risk of the disease’s progression. In 2000, with the drug Interferon, it was 60-percent effective. Now, with Glivec, effectivity has increased to 97 percent.

There is a step forward every 10 years, Fincato said. By 2020, he hopes they will reach their final answer and possibly finally find a cure to CML. Improvement has also been observed in areas such as breast cancer. While the disease is increasing, the treatment has also been improving, such that the number of deaths and progression have been reduced.

“It is not enough to deliver an innovation. It’s not only a question of how the patients are. It’s a question of what we are doing for the patient,” said Philippe Barrois, Novartis EGM oncology head.

If years ago they were trying to treat the outcome of the disease, said Fincato, today they are trying to treat the cause. Thanks to the knowledge nobody had until a few years ago on genes and pathways, scientists are finally able to select the gene, see how it is organized/constituted, and understand molecular biology and pathways.

More complex

Ovarian and brain cancers are more complex, though, Fincato said. Since there is no pathway identified with both, there is no treatment for them yet. With ovarian and brain cancer, he said, not just one but multiple pathways are involved. He said scientists at Novartis are studying these two diseases very closely.

“We need to understand the pathway to make our drugs work and select the right patients by identifying those who will respond to our medication,” Fincato said.

Apple cofounder and CEO Steve Jobs is on Novartis’ Afinitor treatment. Afinitor is used to treat patients with advanced pancreatic NET—neuroedocrine tumors that cannot be removed through surgery or has metastasized. In its advanced stage, where approximately 60 percent are diagnosed, a five-year survival is 27 percent. With Afinitor, the first new treatment in nearly 30 years, tumor growth and progression are significantly delayed.

Real effort

It was also Novartis that first came out with a vaccine for the AH1H1 flu. A single drug can cost more than $2 billion and can take up to 12 years to develop, test and release, said Rainer Boehm, EVP and Northern American region head for oncology. The company is set to submit more than 60 different drugs for approval in the next five years.

“We make a real effort to find solutions that can improve the quality of life of the patient and delay the progression of the disease; to find something soon which can improve not only the quality of life but also the survival of the patients. We never give up the hope to find the final solution after some time,” Fincato said.

Consideration of patients’ needs is a driver for innovations. For instance, some combination drugs, such as those for hypertension, are now available in just one pill, said Novartis medical director CVM Neelesh Dongre. So instead of taking two or three separate tablets at given time of the day, patients just need to take one.

“It’s been shown that the more tablets you have to take, the more chances of you forgetting your pills,” Dongre said.

Dorje Mundle, group head of corporate citizenship, said Novartis last year was able to benefit more than 900 million people worldwide through vaccines and medications. One in 11 receives treatment via access-to-medicine programs.

“It’s not just about manufacturing more pills. One-third of patients taking Glivec, used to treat CML, is getting medication through this program,” Mundle said.

Filipino CML patients who wish to avail of Novartis’ access-to-medicine program in the country may get brochures from their doctor’s clinic for mechanics and requirements on how to qualify.