What’s in a name? With cancer drugs, more than you might think

When it comes to naming children — at least in my generation — it was pretty straightforward.

For example, one of my sisters is named after my father's mother, and my first name is the same as my grandfather’s.

Traditionally, you would name your children after a senior member on either side of the family out of respect.

Today, it seems to be a bit different.

The first daughter of one of my nephews is named Brooklyn. Not surprisingly, no one in the family has that name, despite the fact that everyone is a New Yorker.

I teasingly asked him if his next children would be named Manhattan, Bronx and Staten. I told him to stay away from Queens and Flushing.

‘mabs’ and ‘ibs’

I bring this up because I always wondered how the names of cancer drugs are established — especially in the era of immunotherapy, antibody-drug conjugates and targeted agents.

I'm sure medical oncologists and hematologic oncologists are familiar with this but, as a simple surgeon, I was not. Basically, I spent time learning how to pronounce these agents. For example, try to say ipilimumab five times fast!

As a starter, the end letters are the stem of the generic names. They are like surnames that tell what family the drug is from and how the drug targets or kills the cancer cells.

Monoclonal antibodies end with the stem “-mab” and small molecule inhibitors end with the stem “-ib”.

So, if we take ipilimumab (Yervoy, Bristol Myers Squibb), consider that the “mabs” family of drugs is utilized when receptor targets are overexpressed on the outside of the cancer cell.

The sub-stem of the generic name of the drug in the ”mabs” family identifies the source where the antibiotics were cloned or generated.

There are three common sources. The first is chimeric human mouse drugs, which end in “ximab” — like rituximab (Rituxan; Genentech, Biogen).

The second most common source is humanized mouse, which are drugs ending in “zumab” — such as bevacizumab (Avastin, Genentech).

The third most common source is fully human drugs ending in “mumab” — as in the aforementioned ipilimumab.

The “simplicity” of this does not end here. Both ”mabs” and “ibs” contain an additional stem that describes the therapy’s target.

For example, the ‘tu’ in rituximab indicates the target is the tumor, the ‘ci’ in bevacizumab refers to the circulatory system and the ‘li’ in ipilimumab identifies the immune system target.

To take this further, an example of the intracellular targets for the “ibs” would be tyrosine kinase inhibition with the sub-stem “tinib” seen in imatinib.

Creative ‘brand’-ing

When it comes to brand names, there is a little more creativity.

The names are meant to identify the drugs in some way. They can represent some type of sound or type of image.

An example is Ibrance — the brand name for palbociclib, a breast cancer therapy developed by Pfizer. It can represent the process of being mentally stimulated or to do something creative.

It wouldn’t surprise me if companies think about names that would increase the chances for FDA approval. This goes under the category of “What a great country!”

OK, I know drugs undergo a meticulous review by the FDA.

Of course, there is always a company that will take a classic song to advertise their drug.

One example in the cardiology world is the Sonny and Cher song “The Beat Goes On,” used for the drug sacubitril/valsartan (Entresto, Novartis).

The ad shows an X-rayed beating heart, then reveals the people behind the heart enjoying simple pleasures in life, such as preparing a meal or enjoying time with their spouse.

"The Beat Goes On" supports and emphasizes the storyline of people going on, even with cardiovascular disease.

Sonny is turning over in his grave — although I wonder if Cher is getting royalties from that. Like she needs it!

The bottom line is that I remembered that advertisement, so the idea that catchy songs are retained in memory works.

It is the most common technique for enhancing product recall through increased memorability. Also, as I mentioned in one of my previous commentaries, music has the ability to evoke a range of emotions.

Well, whether it is Brooklyn or Ibrance, tomato or tomahto, what’s in a name?

“That which we call a rose by any other name would smell as sweet.”

William Shakespeare uses this line in “Romeo and Juliet” to convey that the naming of things is irrelevant. But not so with cancer drugs!

Stay safe.

For more information:

Nicholas J. Petrelli, MD, FACS, is Bank of America endowed medical director of ChristianaCare’s Helen F. Graham Cancer Center & Research Institute and associate director of translational research at Wistar Cancer Institute. He also serves as Associate Medical Editor for Surgical Oncology for HemOnc Today. He can be reached at npetrelli@christianacare.org.