'Wonder drug' less effective if used late in illness, studies show A costly 'wonder drug' for cancer should be given to patients as early in their illness as possible, because the later it is used the less effective it becomes, a meeting of experts was told yesterday. World cancer authorities meeting in Hong Kong said resistance to Glivec could occur in 80 per cent of patients in the later stages of their illness. Timothy Hughes, clinical associate professor of medicine at the University of Adelaide in Australia, said the latest findings showed that 97 per cent of chronic myeloid leukaemia patients taking Glivec survived for at least four years - almost double the rate of those on traditional cancer drugs. 'If this trend continues, the majority of patients may live beyond 10 years,' Professor Hughes said at an annual scientific meeting held by the Hong Kong Society of Haematology and the Hong Kong Association of Blood Transfusion and Haematology. But he warned that more than 80 per cent of patients near the end stages of their illness did not respond to Glivec, and 60 per cent of patients in the accelerated phase - when their condition begins to deteriorate - were also resistant. 'But if you start the drug early and if you get a good initial response, then you have the incidence of less than 5 per cent [of drug resistance],' Professor Hughes said. Glivec has been the subject of heated debate in Hong Kong recently, after the Hospital Authority decided not to subsidise its use. Glivec costs $16,000 to $20,000 a month per patient. Patients who cannot afford the drug may be eligible for help from the Samaritan Fund charity, subject to a means test. Professor Hughes said Glivec had been adopted as a first-line drug in most developed countries. The Australian government has been heavily subsidising its use for two years as first-line therapy, and for four years as therapy for patients in the acute phase of the disease. Albert Lie Kwok-wai, honorary clinical associate professor at the University of Hong Kong, said the drug became ineffective in about 16 out of every 20 patients who started to use it at a later stage of their illness. Those patients die because no alternatives are available. Dr Lie said several patients at Queen Mary Hospital, HKU's teaching hospital, could not afford the drug and were still waiting for help from the Samaritan Fund. In Hong Kong, there are about 250 patients with chronic myeloid leukaemia - one of the four most common types of the disease - and 50 new cases a year.