Even seemingly complicated names like the newly approved
chimeric antigen receptor T-cell product for relapsed/refractory
acute lymphocytic leukemia, tisagenlecleucel, can be broken
down into their constitutive etymologic parts. The unique
component of the name tisa- evokes T cells, but all the rest is
formula: -gen implies transfer of genetic material in the CD19/
costimulatory construct, -lec- designates selection and manipu-
lation for cell enrichment, -leu- stands for leukocytes, and -cel
indicates it is a cellular therapy.
The drug-naming process is
complicated and is reminiscent of
the 1970s “Schoolhouse Rock!” jingle
about the gauntlet “just a bill” must
travel to become a law.
Brand Awareness
After undergoing all of these naming layers – developmental
name, IUPAC name, registry designations, non-proprietary/
generic name – a single drug already has as many names as
Andrew Lloyd Webber’s Jellicle Cats, even before the market-
ing people get involved. Unlike generic names, commercial
names created by marketers can vary by country and need to
be approved by the U.S. Food and Drug Administration (FDA),
European Medicines Agency, or other regulatory agencies.
Brand names sometimes seem purposefully designed to be
simpler than the non-proprietary names so clinicians will use the
trade name preferentially. While physicians can certainly handle
long words – seven-syllable “hydrochlorothiazide” rolls off the
tongue for most of us – it is much easier to say the three-syllable
“Yescarta” than the nine-syllable linguistic disaster “axicabtagene
ciloleucel.” “Synribo” certainly beats “omacetaxine mepesuccinate”
hands down. “Lasix” is a brilliant brand name, partly because it
conveys the message that the drug’s activity lasts about six hours
and partly because it has half as many syllables as “furosemide.”
The same constraints about clarity and connotation also apply
to brand names. The FDA worried that “Glivec,” the European
brand name for imatinib, could be confused with a hypoglycemic,
so the brand name in the U.S. became “Gleevec.” “Rev-imid”
would have been a great name for a “revolutionary new IMiD,”
but apparently this sounded too much like French slang for “wet
dream,” so an “l” was added, and we now have “Revlimid.”
The preponderance of high-scoring Scrabble letters like x, j,
z, and q in brand names is intentional as they connote “high-tech”
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and “cutting-edge,” and are harder
to confuse with real words.
Just as diseases are only
rarely named after patients – Lou
Gehrig’s disease and Münchausen
syndrome are on the small list of
exceptions – it is uncommon for
a person’s name to make it into a
drug. But there are a few exam-
ples, such as “dasatinib,” named
in honor of Bristol-Myers Squibb
researcher Jagabandhu Das,
PhD, who made key suggestions
about its chemical structure at an
early stage of development.
David Steensma, MD, is senior
physician at the Dana-Farber
Cancer Institute and associate
professor of medicine at Harvard
Medical School.
Rumor Has It …
Folk etymology is the bane of linguists, who have to explain
again and again that woodchucks never had anything to do with
lumber, and that a bonfire is not French for “good fire.” These ur-
ban legends also plague drug names. Since drug companies don’t
have to provide any rationale for the proposal of either generic or
brand names, the origin can be quickly obscured.
Where did the ima- in imatinib come from? I’ve been told
by several people that because it is the mother of all kinase
inhibitors, it was given the prefix ima-, the Hebrew word for
mother. I’ve also heard that it means, “I’m a TKI!”, reminiscent
of “Hello, My Name Is …” nametags at high school reunions.
I was even once told (confidently!) by a colleague that it was
named after Chinese-American architect I.M. Pei, because
imatinib’s structure fits into ABL kinase as perfectly as a Pei-
designed