Talk:Imatinib

Making this article current?
This article seems outdated to me, if someone would like to take the initiative, here are some resources: http://pdbbeta.rcsb.org/pdb/explore.do?structureId=3K5V http://www.nature.com/nature/journal/v463/n7280/full/nature08675.html http://www.ncbi.nlm.nih.gov/pubmed/12654251?dopt=Abstract (129.128.157.245 (talk) 18:02, 25 April 2010 (UTC))

older entries
Sodium, my compliments on your additions. Please note that in the image, Image:Mechanism imatinib.jpg, the name "Gleevec" is misspelled as "Gleevac". In case you're realllly bored :-)   JFW |  T@lk  22:40, 24 Apr 2004 (UTC)

The story on Imatinib is getting interesting beyond cancer biology. Please see: Imatinib_Attenuates_Diabetes-Associated_Atherosclerosis. M. Lassila et al., Arteriosclerosis, Thrombosis, and Vascular Biology. 2004; 24: 935 - 942 PFHLai 07:25, 2004 May 9 (UTC)


 * This is getting very interesting! If there are more articles being published, it might merit inclusion in the imatinib article! PS I'm going to nominate this article as a Featured article.  JFW |  T@lk  09:01, 9 May 2004 (UTC)

In accordance with WikiProject_Drugs naming policy, I propose we move this page to the INN Imatinib mesylate. If you have any concern with this proposal, please discuss it on this page. Matt 17:46, 23 Dec 2004 (UTC)


 * I'll do it now :-) JFW | T@lk  18:25, 23 Dec 2004 (UTC)
 * Heh, after discussing it at wikiproject_drugs, I agree that it should stay at imatinib, and I'll change the drug list to reflect this. Matt 21:23, 23 Dec 2004 (UTC)
 * Done, and I've added a redirect for imatinib mesilate as well. Techelf 03:49, 22 Mar 2005 (UTC)

INN is Imatinib mesilate, not mesylate. In fact, it is mesylate salt, but INN uses "i" in similar names. Shouldn't we change it ? --Mykhal 18:20, 9 Jan 2005 (UTC)
 * The Novartis documentation refers to it as 'imatinib mesylate'. Is there a standard wikipedia policy on whether the INN or USAN (if either) should be followed? --moof 18:08, 1 February 2006 (UTC)

Follow-up

 * this agent works in imatinib resistance, but only in animal models. I suggest we wait until it has reached Phase III stages. JFW | T@lk  16:49, 28 Feb 2005 (UTC)


 * The added comment about smallpox is in this advance online publication article. We need to monitor when it appears in print to include the reference. JFW | T@lk  29 June 2005 15:27 (UTC)

Reference was inserted
TAYLOR, J. R., BROWNLOW, N., DOMIN, J. & DIBB, N. J. (2006) FMS receptor for M-CSF (CSF-1) is sensitive to the kinase inhibitor imatinib and mutation of Asp-802 to Val confers resistance. Oncogene, 25, 147-51.


 * This was inserted into the article. I'm not sure whether it is necessary to mention this in the article. JFW | T@lk  14:05, 17 January 2006 (UTC)

Heart failure
doi:10.1038/nm1446 - oops. JFW | T@lk  10:26, 28 July 2006 (UTC)

Image
Would anyone object to my replacing the current JPG image of c-abl kinase with a PNG version? Both versions for comparison:

If there are no objections I'll go ahead and change it. I would boldly do so right now, but after seeing the current image has been in place for well over a year, I thought it best to ask first. Thanks, Fvasconcellos 14:35, 8 November 2006 (UTC)
 * No objections after two days, I'm changing it. Again, if anyone would like to revert to the previous version, go ahead, or leave a message on my Talk page. Fvasconcellos 13:16, 10 November 2006 (UTC)

India
- legal analysis on patenting of drugs in India. JFW | T@lk  21:26, 13 February 2007 (UTC)

Impact of HSCT
Less transplants thanks to imatinib JFW |  T@lk  22:58, 2 May 2007 (UTC)

heart failure
Actually relatively rare in imatinib use JFW |  T@lk  06:40, 7 August 2007 (UTC)

When they get pregnant
CML may occur in young women, and after 10 years there is a small database of women who carried to term having taken imatinib at some point in their pregnancy. A stereotypical set of congenital abnormalities has been identified: JFW |  T@lk  20:23, 22 June 2008 (UTC)

"In CML, the enzyme tyrosine kinase is stuck in the "on" position"
Would like clarification of what this actually means. I wasn't aware enzymes had on/off "positions" - perhaps its referring to gene transcription instead? Evercat (talk) 17:50, 2 December 2009 (UTC)

It's metaphorical, not literal. It means that the enzyme is continuously active instead of becoming inactive when it should. —Preceding unsigned comment added by Rbethune (talk • contribs) 22:56, 29 December 2009 (UTC)
 * I've seen this wording in peer-reviewed journals and many science magazines. They even talk about "brakes" and "accelerators". When a scientist explains something, their goal is to have their audience understand it, not to pedantic, Latinate language. Even Nobel laureates explain technical ideas in everyday metaphors.
 * The real sin is to write in language so formal and technical that people post messages in Talk saying, "I can't understand this, it's too technical." What's the purpose of writing something if your readers can't understand it? --Nbauman (talk) 17:17, 1 April 2013 (UTC)


 * I just saw it again.


 * We now have a vastly enriched understanding of how this runaway growth begins. Cancer results from alterations to cellular genes. In normal cells, powerful genetic signals regulate cell division with exquisite control. Some genes activate cellular proliferation, behaving like minuscule accelerators of growth. Others inactivate growth, acting like molecular brakes. Genes tell a limb to grow out of an embryo, for example, and then instruct the limb to stop growing. A cut prompts the skin to heal itself, but heaps of skin do not continue to grow in excess. In a cancer cell, in contrast, the accelerators of growth are jammed permanently on, the brakes permanently off. The result is a cell that does not know how to stop growing.


 * , The Riddle of Cancer Relapse, The Cancer Sleeper Cell, New York Times, October 29, 2010


 * Metaphors are a common explanatory device used by good science writers. One of the standard metaphors of cancer cells is that of accelerators and brakes. --Nbauman (talk) 23:20, 1 April 2013 (UTC)

I actually did look it up. Many WP:RS refer to CML as a disease in which the accelerator gets stuck in the "on" position. Yes, enzymes do have "on" and "off" positions. That's the language of science.

http://www.cancer.med.umich.edu/research/leukemia-stemcells3.shtml University of Michigan Comprehensive Cancer Center Leukemia Stem Cell Research In leukemia, however, the self-renewal process is out of control. Mutations that inactivate tumor suppressors or activate growth promoting signals allow malignant stem cells to disable or ignore the body's natural control mechanisms. It's like the cancer gets the go signals, but not the stop signals - as if the accelerator gets stuck in the "on" position -- and the stem cells make many more cells than the body can use.

http://www.novartisoncology.us/education/diseases-conditions/hematology/cml.jsp Novartis Oncology Chronic Myeloid Leukemia In about 95% of patients with CML, a defect in a chromosome (the genetic material) in the leukemia cells occurs. This defect is called the Philadelphia chromosome, named for the city where it was discovered, this abnormal chromosome forms when 2 chromosomes in the cell swap their genetic material. It is not clear what causes this to happen. Because of this event, a protein that normally helps to regulate the production of new white blood cells in the bone marrow—the Abl protein—becomes stuck in the "on" position, telling the body to keep making more abnormal blood cells.

--Nbauman (talk) 23:30, 1 April 2013 (UTC)

Gleevec target
ARG is also affected by Gleevec. ARG tyrosine kinase activity is inhibited by STI571. Keiko Okuda, Ellen Weisberg, D. Gary Gilliland, and James D. Griffin (2001). 74.210.192.17 (talk) 00:12, 8 December 2009 (UTC)

Cost of imatinib
The figure of $92,000 per year cited without support in the article concerns me. I don't think it's accurate, but it is being widely cited around the Internet and even in print publications, usually without attribution to Wikipedia, but usually using verbatim text from this article. I have not been able to find a source for this figure that does not actually trace back to this very article - circular verification, as it were!

I am a CML patient on imatinib. I am intensely aware of the cost issue, since it is far beyond what I could afford if I were to lose insurance coverage. Although it is not easy to find cost information on imatinib, I have been able to find some sources, two of which I cite in my edit of the article done just now. I am unable to document anything close to the $92,000 figure for 400 mg/day. The high $40K's is what I generally come up with. I have therefore left the text that I found alone, but added two more paragraphs with additional sources and information. —Preceding unsigned comment added by Rbethune (talk • contribs) 23:02, 29 December 2009 (UTC)


 * I am a CML patient on Gleevec, and my insurance regularly (as of 2015) pays $8000 for a 30-day dosage. this comes out pretty close to the $92,000 per year. Sorry I don't have a citation, but the figure is accurate.  Tim Bird (talk) 19:58, 23 October 2015 (UTC)

Hair Color Restoration
Cancer drug restores hair colour http://news.bbc.co.uk/2/hi/health/2180244.stm

One of the side effects of this drug is that it can restore hair color in graying individuals. I don't see mention in this article about this topic but I see it in Hair Color —Preceding unsigned comment added by 69.137.14.133 (talk) 23:59, 5 February 2010 (UTC)

It's true - it can happen. It happened to me - I was not very grey to begin with, but my hair has darkened and there is no grey left. Strange side effect! I have stopped taking Imatinib, so expect grey hair to reappear. --93.96.152.208 (talk) 16:12, 27 February 2013 (UTC)
 * I stopped taking imatinib, my hair started to go grey again. Oh well. --2.127.118.102 (talk) 10:24, 28 May 2013 (UTC)

Primary source fest
WP:MEDRS suggests that we should base our content as much as possible on secondary sources. This article is now full with allusions to primary research papers that have tipped some imatinib in a Petri dish with sick cells. How much of this content can we tolerate? Or should we find a paper that enumerates all uses of imatinib? It must be out there. JFW | T@lk  10:24, 26 September 2010 (UTC)

Cleanup / Corrections
This article is formatted a bit strange to me. Seems more information should be put into explaining how Imatinib works as well as how effective it truly is against leukemia. Also I am not seeing any citations... Will try to clean this one. — Preceding unsigned comment added by Gleevec (talk • contribs) 09:31, 15 December 2012 (UTC)

Clarification of lead compound
In para 2 of the History section of the article, there is a reference to a "lead compound". Perhaps this should be changed to "initial compound", as it does not actually contain lead! 86.4.253.180 (talk) 18:12, 3 April 2013 (UTC)
 * Not sure. "Lead compound" is the technical term. I've linked it to the appropriate explanation, does that help? --ἀνυπόδητος (talk) 18:49, 3 April 2013 (UTC)

C-kit protein in skin as well as GIST
Article says that Gleevec is targeted but it also attacks the skin. The c-kit protein is in skin as well as GIST tumors.

http://www.gistsupport.org/ask-the-professional/skin-related-side-effects-of-sunitinib.php 71.90.171.82 (talk) 20:09, 18 December 2013 (UTC)
 * unclear what your point is. the section on potential side effects, determined from clinical trials, already mentions skin problems.Jytdog (talk) 20:33, 18 December 2013 (UTC)

Law and Order
Hi, people, I think it'd be great if I could add that it made an appearance in a Law and Order episode but I'm stuck on what the funky chicken I'm meant to cite for this?

Time magazine cover
The "fair use" criteria for a magazine cover are: The use in this article is not about the publication of the issue. We cannot use it here. Jytdog (talk) 11:53, 5 November 2014 (UTC)
 * to illustrate the publication of the issue of the magazine in question
 * with the publication name either visible on the image itself or written in the image description above,

Reference to Vasella's book
It would seem worthwhile for the Imatinib article to mention the popularization Magic Cancer Bullet by Daniel Vasella. This book may not add any technical or historical detail to the page, but it is a notable event related to the drug.Andrew Oram, Editor, O'Reilly Media, http://praxagora.com/andyo/ 19:45, 12 December 2014 (UTC) — Preceding unsigned comment added by AndrewOram (talk • contribs)
 * username of wikipedia user = editor of book. Same person? Jytdog (talk) 22:50, 12 December 2014 (UTC)

If you're curious, check out my or. — Preceding unsigned comment added by AndrewOram (talk • contribs) 07:08, 21 February 2018 (UTC)

Overdose section
The section on "Overdose" has nothing about overdose, and instead has a long list of minor side effects.

WP:MEDMOS "a long list of side effects is largely useless without some idea of which are common or serious."

I propose deleting the "Overdose" section. Any objections? --Nbauman (talk) 15:28, 26 July 2015 (UTC)


 * I would think that the valid argument(s) would be that the pedantic transliteration of what looks like the entire en bloc section in the Australian package insert is either UNDUE or perhaps COPYVIO. Trimmed to a short haircut. Is that adequate, or do you prefer to remove in toto? FeatherPluma (talk) 16:41, 26 July 2015 (UTC)
 * I think the whole thing should go. Do you see any useful information there? I haven't heard of imatinib overdoses being a significant problem. --Nbauman (talk) 21:05, 26 July 2015 (UTC)

Why was Mesylate salt used
Is it just for manufacture/packaging, or does it have some benefits when taken orally ? - Rod57 (talk) 11:12, 14 September 2015 (UTC)
 * The discussion of the Indian patent seems to imply it was mainly for patentability/legal reasons, not efficacy. - Rod57 (talk) 11:10, 17 November 2017 (UTC)

How is the mesylate salt formed
In the diagrams of Imatinib - what is removed/changed to create the imatinib ion in the salt ? - Rod57 (talk) 11:12, 14 September 2015 (UTC)

What is the importance of the beta crystalline form
Eg does it affect the solubility or absorption in the gut ? - Rod57 (talk) 10:52, 14 September 2015 (UTC)

New generic version
Teva and Apotex debut generic Gleevec drugs in the USA.Uziel302 (talk) 12:11, 7 August 2016 (UTC)

Cost justification
The Cost section has "A 2012 economic analysis funded by Bristol-Myers Squibb..." gives figures including 'related drugs' - We should replace them with the figures (in the ref) for just Imatinib, and perhaps clarify the methodology - how the various values were arrived at. ? - Rod57 (talk) 11:08, 17 November 2017 (UTC)

Synthesis image - original work - no source?
The SVG image in the Synthesis section provides a mechanism but there's no source presented, the image is an original work (which is fine) by @葉智海 but no source or credibility is given. There is no user page in wikipedia or wikimedia commons for that image. Can anyone find a source for the synthesis of imatinib? QueensanditsCrazy (talk) 21:28, 3 May 2021 (UTC)