Genentech Data Bring Jitters

In Europe, the chemotherapy regimen most commonly used to treat lung cancer patients is cisplatin and gemcitabine, so investigators there ran a phase III study -- dubbed AVAIL -- looking to see whether the addition of Avastin would also benefit patients.

Like in the U.S., Avastin worked when added to the European chemo regimen, but it was slightly more effective at a lower dose (7.5 mg) compared to the higher dose (15 mg) used in the U.S.

When investigators looked at the safety data for the two Avastin doses, the low dose also appeared superior to the high dose across most categories.

The worry for Genentech from a business perspective is that a lower dose of Avastin equates to lower revenue. While this revenue falloff may be contained to Europe, where the Avastin plus cisplatin-gemcitabine regimen is used more, there is the possibility that oncologists here will interpret these data to mean that they can also use a lower dose of Avastin in combination with carboplatin and paclitaxel.

Investors have digested some of the negative impact of the AVAIL study already. When top-line results were announced earlier this year, sell-side analysts cut their Avastin revenue forecasts accordingly.

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In the second kidney cancer study, the combination of Avastin with interferon doubled progression-free survival to 10.2 months, compared with 5.4 months for patients given interferon alone. The tumor response rate for the Avastin regimen was 30.6% compared with 12.4% for the interferon-only arm of the study.