Finding New Hope In A Medical Miracle Drug – STI-571

By Kaaren Valenta

When Joseph Andrews, 64, noticed spots on his legs, he thought he had been bitten by insects while helping his son work on a cottage at Lake Wolcott.

Despite treatment, the sores remained. It wasn’t until nearly six months later, when his legs turned red and began to swell, that he learned the cause. Doctors at St Vincent’s Hospital delivered the devastating news that the 64-year-old Newtown resident had chronic myelogeneous leukemia (CML).

“He was diagnosed in November 1999 but the doctors said Joe probably had leukemia for at least two years,” Mr Andrews’ wife, Pat, said. “Fortunately he was still in what is called the chronic stage. It hadn’t reached the accelerated stage. That usually happens by the third year.”

Treatment began but Joe Andrews’ prospects looked grim until Mrs Andrews heard about an Oregon doctor, Brian Druker, who was conducting a clinical trial of a new drug, STI-571, through a grant funded by the Leukemia & Lymphoma Society. STI-571 is believed to be a new breakthrough in leukemia therapy. Unlike chemotherapy, which kills both normal and abnormal cells in an attempt to cure the cancer, STI-571 targets the enzyme found only in the leukemia cells, leaving normal cells unscathed.

 “We called Oregon last May to see if Joe could be tested for the study and were told they only take two [patients] a week and they were booked until July,” Pat Andrews said. “I started calling again the first week in July. I used to be a medical secretary so I know a little about these things. I was relentless.”

She finally reached Dr Druker through an email message and he responded by calling her.

“Getting included in the study is like winning the lottery, so we were ecstatic,” Mrs Andrews recalled.

“Joe passed the qualifying tests – a bone marrow biopsy showed that all of the cells in his bone marrow had been affected by the leukemia. He had what is called the Philadelphia chromosome, and he had been unable to tolerate treatment with the drug Interferon. But the drug study required that the patient also must have been diagnosed at least six months earlier through the bone marrow biopsy, so even though we knew Joe had leukemia more than two years, he still had to wait another six months.”

Finally word came that Joe Andrews had an appointment last July 31 for a biopsy. The couple flew to the Oregon Health Sciences University hospital in Portland on a flight provided by Corporate Angels, a volunteer group that provides free medical flights for critically ill people. “The Corporate Angels were fabulous. They treated us like royalty,” Pat Andrews said.

On August 3, Joe Andrews took the first dose of STI-571.

When the couple returned to Newtown, Pat’s mother was hospitalized and died two weeks later.

“Joe was visiting her in the hospital and picked up some bug,” Mrs Andrews said. “He had only been on the drug a short time but it had been working so fast that he had virtually no immune system. Within six weeks the number of leukemia cells were down 50 percent. But he was so ill that he was hospitalized for two months with pneumonia, a fungus infection, and temperatures that soared to 104 degrees, and had to have two transfusions. He lost 20 pounds and we didn’t think he would live.”

When he finally recovered and was discharged from the hospital, the decision was made to put him on the drug on a six-weeks on, six-weeks off schedule, Mrs Andrews explained. “We went back to Oregon on January 22 and they said that 65 percent of the leukemia cells were gone. ”

Mr Andrews is being treated in Connecticut by Dr E. Andrew Duda, an oncologist in Fairfield, who supported the Andrews’ efforts to become part of the drug trial.

According to a feature story, The Miracle Worker, about Dr Druker in the February 19 issue of People magazine, the early results of the study have been astonishing. In the first trial, all 31 CML participants had their cancer go into remission. Since then clinical trials have been extended to 30 countries and more than 2,800 patients, including Joe Andrews, who is one of 300 patients being treated in Oregon. Over 90 percent of those in the disease’s chronic phase have seen their white blood cell counts return to normal, and one-third of those have no detectable traces of leukemia.

The drug – four mustard colored capsules taken once a day – has minimal side effects, mainly mild nausea and muscle cramps. Joe Andrews experienced a rash, itching, and swelling the first times he took the drug, but has had no reaction during the last cycle. Best of all, his last blood test showed counts that were normal. All during his illness, he never lost hope.

 “Since my diagnosis, I have been coping best by not letting myself feel sick, having a positive attitude, and placing my hope in the miracle drug STI-571,” Mr Andrews said. “Dr Druker is my hero.”

Joe Andrews, a retired telephone company cable splicer, was the first adult in Connecticut to be put on the drug. A young boy from Ridgefield, John McCaffrey, was the first child to be included in the study, which was intended only for adults. It was through the television show about Dr Druker, which included a segment about John McCaffrey, that the Andrews learned about the drug. They eventually met the young boy while in Oregon when he was also receiving treatment.

The Andrews have two grown sons, Jay, 30, a carpenter, and Scott, 28, a medical technician who hopes to become a doctor. Joe Andrews had always been healthy until 11 years ago when he was diagnosed with a brain tumor. It was not malignant, however, and was successfully removed at Yale New Haven Hospital. Then he had appendicitis. Then the leukemia.

“You hear about these things but you never think they will happen to you,” Mr Andrews said. “But if I can continue to feel as good as I do now, I’ll be happy.”

His last blood test showed blood platelets and white cell counts that were all in the normal range, so he is optimistic that he will beat the leukemia. He plans to go to Anchorage, Alaska, in June for the Mayor’s Midnight Sun Marathon, where he will be the “honored teammate” for a group of runners who are raising money for research and awareness of leukemia.

On April 3, the Leukemia & Lymphoma Society and the Carl and Dorothy Bennett Cancer Center are cosponsoring a seminar at Stamford Hospital entitled “Are Clinical Trials Right for You?” The free program will be held in the Brace Auditorium at 5:30 pm. Featured speakers include Salvatore Del Prete, MD, a medical oncologist; Deanna Xistris, an advanced practice registered nurse who specializes in oncology; and John Shaw, CML survivor and STI-571 patient. Mr Andrews also will be attending the event.

An estimated 1.2 million Americans will be diagnosed with cancer this year, with 15,000 new cases in Connecticut. Clinical trials are research studies used to evaluate new treatments and compare them to standard therapies.

“People today are better off because of those who underwent treatment in clinical trials before them,” Andrews said.

Sometime in April, Mr Andrews will be returning to Oregon for another biopsy. But he and his wife are convinced the news will be good.

“He feels so good that he’s running circles around me,” Pat Andrews said. “I can’t believe how far we have gone in so short a time.”

For information about the seminar on April 3 or to make a reservation, call Phyllis Osterman, patient services manager at the Leukemia & Lymphoma Society, at 203-967-8326. More information also can be found on the Web site www.leukemia-lymphoma.org.