This Day On The Street
Continue to site
ADVERTISEMENT
This account is pending registration confirmation. Please click on the link within the confirmation email previously sent you to complete registration.
Need a new registration confirmation email? Click here

Making The Call: Celgene's Abraxane Will Work in Pancreatic Cancer

Compared to FOLFIRINOX, Abraxane appears to cause less severe vomiting, diarrhea and febrile neutropenia, a sign of infection. However, Abraxane is responsible for more severe thrombocytopenia (low platelets) and sensory neuropathy, or nerve damage, in the arms and legs, than FOLFIRINOX

Febrile neutropenia and sensory neuropathy are the most worrisome side effects for each drug, with good reason. An infection with a low white blood cell count can kill, and persistent, severe tingling of the hands and feet can meaningfully impair quality of life. (Consider Celgene's Thalomid and Takeda's Velcade, both of which have been hindered commercially by a tendency to cause sensory neuropathy.)

The most common pushback against FOLFIRINOX becoming widely used in pancreatic cancer is that the regimen is too toxic for patients to tolerate. I don't think that's true, at least for relatively healthy patients. Nevertheless, Abraxane's side effects are worth keeping an eye on.

The most significant hindrance to FOLFIRINOX's adoption in the pancreatic cancer treatment landscape may be the simple fact that the four drugs in the regimen are all generic, meaning no company is out there actively marketing it to doctors.

Celgene, however, will be marketing Abraxane aggressively to pancreatic cancer specialists, if approved. The company's salesforce will likely be able to assuage concerns about Abraxane's toxicity, suggest appropriate patients for initial use, and highlight potentially compelling details in the dataset -- such as the possible correlation between high levels of secreted protein acidic and rich in cysteine, a membrane protein known as SPARC, and longer median survival.

There is one point of concern that makes me a little nervous. Based on an interim analysis, the independent monitors overseeing the Abraxane pancreatic cancer study recommended to Celgene that the trial increase in size by nearly 34%. That's potentially important, as it could indicate the data monitors saw a smaller-than-expected benefit for Abraxane versus control during the interim analysis. It's more likely that I'm being too much of a worrywart.

In aggregate, the data suggest Abraxane will have favorable risk-benefit profile in pancreatic cancer. Current analyst consensus estimates include only roughly $730 million in 2015 Abraxane sales across all indications, well below management's guidance of sales reaching $1 billion to $1.25 billion. That suggests most Street analysts don't expect the drug to work. Clearly, success in phase III would force those projections upwards.

Time will tell.

Two related notes: Read Jim Silverman's column on buying the Celgene contingent value rights (CVR) (CELGZ) as a bullish trade tied to the positive outcome in the Abraxane pancreatic cancer trial.

If Abraxane demonstrates a clinically meaningful survival benefit in pancreatic cancer, Threshold Pharmaceuticals' (THLD - Get Report) pancreatic cancer drug TH-302 could be obsolete even before its phase III study is completed.

Sadeghi has no position in Celgene.

Follow Nathan Sadeghi-Nejad on Twitter.
Nathan Sadeghi-Nejad has 15 years experience as a professional health-care investor, most recently as a sector head for Highside Capital. He has worked on the sell side (with independent research boutiques Sturza's Medical Research and Avalon Research) and the buyside (at Kilkenny Capital prior to Highside). Sadeghi-Nejad is a graduate of Columbia University and lives in New York. You can follow him on Twitter @natesadeghi.
2 of 2

Check Out Our Best Services for Investors

Action Alerts PLUS

Portfolio Manager Jim Cramer and Director of Research Jack Mohr reveal their investment tactics while giving advanced notice before every trade.

Product Features:
  • $2.5+ million portfolio
  • Large-cap and dividend focus
  • Intraday trade alerts from Cramer
Quant Ratings

Access the tool that DOMINATES the Russell 2000 and the S&P 500.

Product Features:
  • Buy, hold, or sell recommendations for over 4,300 stocks
  • Unlimited research reports on your favorite stocks
  • A custom stock screener
Stocks Under $10

David Peltier uncovers low dollar stocks with serious upside potential that are flying under Wall Street's radar.

Product Features:
  • Model portfolio
  • Stocks trading below $10
  • Intraday trade alerts
14-Days Free
Only $9.95
14-Days Free
Dividend Stock Advisor

David Peltier identifies the best of breed dividend stocks that will pay a reliable AND significant income stream.

Product Features:
  • Diversified model portfolio of dividend stocks
  • Updates with exact steps to take - BUY, HOLD, SELL
Trifecta Stocks

Every recommendation goes through 3 layers of intense scrutiny—quantitative, fundamental and technical analysis—to maximize profit potential and minimize risk.

Product Features:
  • Model Portfolio
  • Intra Day Trade alerts
  • Access to Quant Ratings
Options Profits

Our options trading pros provide over 100 monthly option trading ideas and strategies to help you become a well-seasoned trader.

Product Features:
  • Actionable options commentary and news
  • Real-time trading community
SYM TRADE IT LAST %CHG
CELG $135.42 0.00%
THLD $4.30 0.00%
AAPL $123.38 0.00%
FB $95.29 0.00%
GOOG $628.00 0.00%

Markets

Chart of I:DJI
DOW 17,630.27 +189.68 1.09%
S&P 500 2,093.25 +25.61 1.24%
NASDAQ 5,089.2060 +49.43 0.98%

Free Reports

Top Rated Stocks Top Rated Funds Top Rated ETFs