dtb:

Imatinib is a fair comparison, as it too was a paradigm-altering therapy for chronic myelogenous leukemia (CML)(1).

Not quite apples-to-apples, though as

- target patent population much less (i.e. two if not three orders of magnitude) for imatinib than GLP-1s

- there were no mimicry/analogue substitute molecules available for a decade or more, while GLP-1s generally need a scorecard only a few years after launch

- imatinib production much easier to scale up (pills) than hundreds of thousands of autoinjectors (which was a major Novo unforced error)

(I’ll also quibble at the use of the ‘cure’ word - which actually makes imatinib, a chronic medication, more like GLP-1s or insulin than other unique paradigm-altering drugs that were truly curative such as penicillin).

But I’ll admit that the GLP-1 pipeline is such that I a) restricted the timeline to five years and b) reserved the right to switch mounts in mid-race.

Thanks for the feedback.

- sutton
(1) who remembers giving a lecture on CML management (such as it was) in around 1991 - a few years before imatinib was released. Grim stuff. The only real debate was where to set the age cutoff for unrelated donor marrow transplants, versus running out the thread with hydroxyurea and/or interferon.

But the coolest thing (you got me started, sorry) is that CML was the first human malignancy where all of the following was elucidated:
- the responsible mutation (as well as why that mutation happens exactly there), AND
- exactly how that mutation led to a leukemic phenotype, AND
- how a theoretical molecule that looked just-like-this could work to reverse the effect of the mutation AND
- when that molecule was synthesized and used it efficiently reversed every overt sign of leukemia (blood, marrow) and normalized patients’ lives.

Just elegant molecular biology as well as a truly remarkable drug.

And while most discoveries are profoundly collaborative, the timely invention of imatinib was largely due to one brilliant researcher, Dr Brian Druker.

(here endeth the lecture)