Imatinib: Paradigm or anomaly?

The introduction of imatinib (Gleevec, Glivec, formerly STI571), an agent targeting the causative molecular event in chronic myeloid leukemia (CML) has been heralded as a major advance in the treatment of cancer. Certainly, the clinical trials with imatinib have validated the concept that a precise understanding of the pathogenesis of a cancer can lead to more effective and less toxic therapies. Despite the success of imatinib, there remains much skepticism that this paradigm will be applicable to more complicated solid tumors. Whether this skepticism is appropriately deserved will be discussed.