The Pill That Could · The Patients Who Waited

The Patients Who Waited, part 3

Bud Romine, the Oregon truck driver in chapters six and ten, died of an unrelated cancer in 2017. His CML, by every test he had had in the years before his death, had remained suppressed. His family donated some of his memorabilia from the imatinib years to OHSU; the postcards from his trucking trips are, I am told, in a small collection of patient artifacts that the cancer center keeps.

Marti Nelson, the California physician who had advocated publicly for accelerated access to Herceptin, died in 1994. She was thirty-seven. She had not been able to enroll in the trial that would, in 1998, lead to the drug's approval; her HER2-amplified breast cancer, by the time the trial slots that might have fit her opened up, had advanced past the point where Herceptin could have helped her. The activism around her case continued for some years after her death. The Nelson Foundation, established by her family and friends after she died, was for a long time involved in supporting expanded access to investigational therapies. She is, in the way these things go, less remembered now than she was twenty-five years ago. She should be remembered.

Some patients from the original phase 1 trial in 1998 — the ones who had advanced disease at enrollment, who had started the drug expecting nothing and gotten years they had not expected — are still alive. Most are not. Many of the ones who responded most dramatically and most durably were already in their fifties or sixties at the time of the trial; they have, since, lived through the natural arc of the rest of their lives, and most of those lives have ended in the ordinary ways that lives end, of the things people in their seventies and eighties and nineties die of. The ones who are still alive are doing well. The ones who are not are, generally, not dead because of the disease the trial was about.

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It is worth saying something, before this chapter ends, about the people who developed the drug.

Brian Druker received many awards over the years that followed Gleevec's approval. He shared the 2009 Lasker-DeBakey Clinical Medical Research Award with Nick Lydon and Charles Sawyers. He has been mentioned, periodically, as a Nobel candidate; he has not, as of 2026, received the Nobel Prize. (Whether he will is, like all such questions, the kind of thing the Nobel committee answers in its own time, in ways that often seem unrelated to the relative merits of the candidates being considered.) He has continued to work on CML and on related questions; he has founded a research institute; he has trained many of the people who, in 2026, are running their own programs at other institutions. He is, by the standards of academic medicine, one of the most successful clinician-scientists of his generation, and is so widely known among CML patients that he receives, by his own account, a steady stream of cards and letters from patients he has never met.

Nick Lydon, the Ciba-Geigy chemist whose lab made the original molecule, has continued to work on kinase inhibitors. After leaving Novartis in 1997, he founded a small biotech company called Kinetix that was eventually acquired by Amgen, then later co-founded Granite Biopharma; he has been involved in several other companies since. He shared the 2009 Lasker with Druker and Sawyers. He has, in the years since, kept a relatively lower public profile than Druker has, in the way that the more inside-the-company half of a successful drug-development story usually does.

Charles Sawyers, who ran the UCLA half of the phase 1 trial and led the work on resistance mutations in chapter nine, has had perhaps the most academically distinguished subsequent career of the three. He moved from UCLA to Memorial Sloan Kettering in 2006, where he founded the Human Oncology and Pathogenesis Program; he has been, in the period since, one of the central figures in the broader field of targeted cancer therapy, with substantial work on resistance mechanisms in prostate cancer and on the development of the second-generation androgen receptor antagonist enzalutamide. He has received the National Medal of Science, the Lasker, several other major awards. He is, in 2026, one of the leading senior figures in American oncology research.

Daniel Vasella stepped down as CEO of Novartis in 2010, having held the role since the 1996 merger that created the company. His tenure included Gleevec's approval and many other drug launches; it also included controversies, particularly around executive compensation, that made him a more politically complicated figure in Switzerland than the Gleevec story alone would suggest. He has continued to write and speak about pharmaceutical innovation in retirement. His memoir from 2003, written before the long-term Gleevec story had played out, remains one of the few primary accounts of the corporate side of the imatinib development effort.

Alex Matter, the Ciba-Geigy oncology research head who had championed the kinase inhibitor program from inside the company, retired from Novartis in 2005 and went on to lead a translational cancer research initiative in Singapore. He is, in 2026, in his eighties, less publicly visible than he was during his Novartis years but still active in cancer research advocacy. The internal champion of a successful drug, in pharmaceutical histories, often gets less credit than the external advocate. Matter's role in keeping CGP 57148 alive through the lean years of the early and mid-1990s was substantial. He is one of the people without whom this story would not have happened the way it did.

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