Imatinib
The drug that started the targeted therapy era in 2001, turning chronic myeloid leukaemia into a manageable condition with near-normal life expectancy.
CML (IRIS: 10-year OS ~83%), GIST (adjuvant 3 years), and rare kinase-driven tumours. Now generic. The proof that a cancer could be switched off by blocking one enzyme.
1.Oral drug is absorbed and reaches the tumour
- Route
- Oral
- Schedule
- 400 mg once daily (chronic-phase CML, GIST adjuvant 3 years); 600-800 mg for advanced disease
- Dose modifications
- Hold for grade 3 neutropenia or hepatotoxicity
- Monitoring
- Blood counts, LFTs, BCR-ABL PCR every 3 months in CML, fluid retention
Source: www.fda.gov/drugs/resources-information-approved-drugs/oncology-cancer-hematologic-malignancies-approval-notifications. Doses are for orientation; the current label governs.
- Medicare
- Part D (self-administered)
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026). Generic imatinib since 2016; often under $100 a month with insurance and far below the Gleevec price.
- Commercial insurance
- covered on label
Multi-source generic on low-cost tiers; usually no prior authorisation. Cash prices without insurance are modest. Brand Gleevec is usually excluded in favour of the generic.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
- Appraised for
- Chronic phase CML (first-line)
- Notes
- Unresectable or metastatic KIT-positive GIST: TA86 (2004). Adjuvant GIST: TA326 (2014). Generic since 2017; now costs the NHS a small fraction of the original price.
- NHS England
- Routinely funded for the appraised indication (or via managed access)
Sources: NICE TA70 · SMC advice: imatinib. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
- 10 May 2001ApprovalUS
Chronic myeloid leukaemia: first targeted kinase inhibitor, approved in under 3 months source
- 1 Feb 2002ApprovalUS
KIT+ gastrointestinal stromal tumour source
- 19 Dec 2008ApprovalUS
Adjuvant GIST source
- 1 Feb 2016ApprovalUS
First US generic imatinib launched source
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2001 | Chronic myeloid leukaemia |
| US | 2002 | KIT+ GIST |
| Adverse event |
|---|
| Oedema |
| Nausea |
| Muscle cramps |
| Diarrhoea |
| Rash |
| Fatigue |
| Neutropenia |
Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
| Country | Reimbursement | List price | Assistance |
|---|---|---|---|
| United Statesgeneric | Medicare Part D; generic since 2016 (list price fell >90%) | not disclosed | — |
| United Kingdomgeneric | NHS standard; generic | not disclosed | — |
List prices are manufacturer or Medicare figures where publicly disclosed; net prices after rebates are usually lower. Reimbursement changes; check the payer.
Trials
topRecruiting now (live from ClinicalTrials.gov)
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IRIS made imatinib the first-line standard for CML worldwide and established the tyrosine kinase inhibitor as a chronic, life-long oral therapy. For most patients CML became a manageable condition with near-normal life expectancy. Later generations of TKIs (dasatinib, nilotinib, asciminib) produce faster, deeper responses but have not shown a survival advantage over imatinib.
Druker's 2001 imatinib paper turned the idea of hitting a cancer's specific molecular engine into a working medicine. For people with CML it began the shift from a fatal disease treated with interferon or transplant to one managed with a daily tablet. It also set expectations, later tempered, that every cancer might have its own imatinib.
Latest papers
topQuery for this drug: (TITLE:"Imatinib" OR ABSTRACT:"Imatinib" OR TITLE:"Gleevec" OR ABSTRACT:"Gleevec") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Imatinib, not a curated reading list.
Pages like this
not linked directly; found by shared links- ProductAsciminib
Shares Molecular response (MMR, MR4, treatment-free remission), Ph-positive ALL, Philadelphia chromosome (Ph+, BCR::ABL1), IRIS: imatinib versus interferon plus cytarabine as first treatment for chronic myeloid leukaemia.
- ProductNilotinib
Shares Molecular response (MMR, MR4, treatment-free remission), Seoul St. Mary's Hospital, IRIS: imatinib versus interferon plus cytarabine as first treatment for chronic myeloid leukaemia, BCR::ABL1 (Philadelphia chromosome).
- ProductDasatinib
Shares Molecular response (MMR, MR4, treatment-free remission), Ph-positive ALL, Philadelphia chromosome (Ph+, BCR::ABL1), IRIS: imatinib versus interferon plus cytarabine as first treatment for chronic myeloid leukaemia.
- ProductPonatinib
Shares PhALLCON, Ph-positive ALL, Philadelphia chromosome (Ph+, BCR::ABL1), BCR::ABL1 (Philadelphia chromosome).
- TermOncogene addiction
Shares Bud Romine, Brian Druker, Tyrosine kinase inhibitor (TKI), Kinase.
- ProductBlinatumomab
Shares Hagop M. Kantarjian, Ph-positive ALL, Philadelphia chromosome (Ph+, BCR::ABL1), Leukaemia (tissue type).
- TermGene fusion
Shares Chromosome, Sarcoma (tissue type), Philadelphia chromosome (Ph+, BCR::ABL1), Janet Rowley.
- ProductSunitinib
Shares PDGFRA, Gastrointestinal stromal tumour (GIST), Thymoma and thymic carcinoma, KIT.