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Imatinib and the long tail of targeted drug development

Nature Reviews Clinical Oncology volume 17, pages 1–3 (2020)Cite this article

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New molecular insights occasionally lead to the rapid development of therapeutic agents that improve the outcomes of patients with cancer; however, these breakthroughs can be followed by extensive, empirically driven and often unsuccessful efforts at extending the drug to other indications or combinations. Herein, we describe the clinical development of imatinib, a paradigm of rapid molecularly driven drug development, and advocate for a balanced portrayal of the potential of molecularly targeted therapies for cancer.

Advances in oncology occasionally come in quantum leaps. New molecular paradigms emerge that speed novel therapies through clinical development and dramatically improve patient outcomes, making drug development look incredibly efficient. Less widely appreciated, however, is the fact that such bursts of innovation are often followed by extensive and generally unproductive research efforts that seem to be driven less by molecular insights than by empiricism. As a result, a research programme that was very efficient initially can become much less so when viewed across its whole life cycle.

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Fig. 1: Accumulating evidence and research organization (AERO)8 diagram of published clinical trials of imatinib.

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Acknowledgements

The work of J.K. is funded by the Canadian Institutes of Health Research (CIHR; EOG111391). Without in any way implying endorsement of the contents of this article, the authors thank members of STREAM and H. Atkins for helpful consultations.

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  1. Studies of Translation, Ethics and Medicine (STREAM), Biomedical Ethics Unit, McGill University, Montreal, QC, Canada

    Benjamin G. Carlisle, Tiger Zheng & Jonathan Kimmelman

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  1. Benjamin G. Carlisle
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  2. Tiger Zheng
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Correspondence to Jonathan Kimmelman.

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Carlisle, B.G., Zheng, T. & Kimmelman, J. Imatinib and the long tail of targeted drug development. Nat Rev Clin Oncol 17, 1–3 (2020). https://doi.org/10.1038/s41571-019-0287-0

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