Big Pharma experienced a rebirth at this year's American Society of Clinical Oncology meeting, grabbing headlines with its new and upcoming cancer therapies, and at the same time putting biotech in the unfamiliar position of playing second fiddle.
At ASCO's 2005 annual meeting, it was biotech bigwig
taking center stage thanks to Avastin. This year, stodgy firms like
served notice that they aren't about to just go gentle into that good night and let a band of slick newcomers claim all the innovations.
Picking the winners at this year's gathering is a fairly simple exercise when viewed from any angle but Wall Street's. Cancer patients, their families and physicians involved in the field of oncology stand to gain from even the smallest advance in the ongoing hunt for better treatments.
However, the fact remains that for public companies researching and developing drugs, shareholders expect clinical successes and for those to translate into capital gains. For investors, what matters is whose stock can be expected to go up and whose stands to go down. Predicting who will do what in that regard is considerably more difficult.
So, even though it wouldn't be exactly fair to say any of the firms involved in this year's cancer conference took a step backward, there were certainly those who undoubtedly moved forward and others that left Atlanta feeling completely rejuvenated.
One of them was Pfizer, whose drug Sutent, already approved to treat kidney cancer, showed positive results against lung cancer. In one trial, Sutent shrank tumors by 50% or more in 9.5% of patients and stopped tumors from growing in an additional 43%, researchers said.
The study marked the first time Sutent was proven effective when used alone in nonsmall-cell lung cancer patients whose disease progressed even following prior treatment with other drugs. Nonsmall-cell lung cancer accounts for about 80% to 85% of lung cancers.
"We feel it looks as good as anything out there in terms of what's already been approved," said Dr. Mark Socinski of the University of North Carolina at Chapel Hill, the lead investigator in the trial. Still, he believes Sutent should be examined in combination with other treatments to see whether it can improve their effectiveness.
The need for finding additional lung cancer options can't be overstated. This year, more than 174,000 new cases of the disease will be diagnosed in the U.S., according to the American Cancer Society. Lung cancer will account for about 13% of all new cancers, and it's the leading cause of cancer death among both men and women. Lung cancer kills more people than colon, breast and prostate cancers combined.
Another traditional drug company, Britain's
, is promising to take on breast cancer with its drug called Tykerb. Trials of the drug, plus the oral chemotherapy Xeloda from
, revealed that the combination provided a significant benefit to taking Xeloda alone.
The trial involved patients whose cancer recurred even after using Genentech's breast cancer drug Herceptin. Patients getting Xeloda went 19.7 weeks before their disease got worse, but for those on the combined treatment, 36.9 weeks passed before their cancer progressed.
Eleven out of 161 patients on just Xeloda saw their cancer spread to the brain, but just four of 160 patients on the joint treatment had brain metastases. Doctors believe that Tykerb, unlike some other breast cancer drugs like Genentech's Herceptin, has the ability to cross the blood-brain barrier to reach brain tumors.
Meanwhile, switching breast cancer patients from standard treatments to the Pfizer drug Aromasin reduces their risk of death, a clinical trial showed. According to the study, patients who made the switch after two to three years on tamoxifen, a commonly used breast cancer treatment, had a 15% lower risk of dying than those who didn't.
said its experimental kidney cancer drug temsirolimus, used alone and as a first-choice treatment, significantly increased the overall survival of patients with advanced disease compared with the standard treatment, interferon-alpha.
Preliminary data from an ongoing trial found that temsirolimus lengthened the lives of patients by about 3.6 months over those treated with interferon-alpha. In patients with advanced cancer, extending lives by a matter of months is considered a significant improvement.
"Until just a few years ago, there were no promising drugs for kidney cancer," said Dr. Gary Hudes of Fox Chase Cancer Center in Philadelphia. "Now there are two that have recently been approved by the FDA and several more that are looking very good in clinical trials."
One of those two new products is the aforementioned Sutent. The other is Nexavar from
Nexavar is approved in the U.S. for patients with advanced kidney cancer, but shares of Onyx were punished Monday after the company said a trial of the drug failed to meet its goal. While Nexavar helped patients live longer than a placebo, the difference didn't meet a prespecified target. However, the results did "suggest a favorable survival trend for patients who received Nexavar," the companies said.
On the other hand, Sutent almost doubled patients' survival time before their disease got worse when compared with standard care. The data were collected in a trial using people who took Sutent as their first treatment.
"There were some side effects, including fatigue and reduced blood-cell counts, but because of the overwhelming superiority and efficacy of this drug, and the fact that the side effects were very well tolerated, the benefits clearly outweigh the costs," said Dr. Robert Motzer of Memorial Sloan Kettering Cancer Center in New York.
A biotech concern that did have a successful trip to ASCO was
. The company's Thalomid, a leprosy drug that was recently approved in the U.S. for treating multiple myeloma, was shown to extend the lives of patients with the blood cancer. Patients also went longer before their disease progressed while taking the drug, which was given in combination with the oral steroid dexamethasone.
Trial data also revealed that a therapy consisting of Thalomid, the chemotherapy drug melphalan and the steroid prednisone was far superior to treatment with either a melphalan-prednisone combination or stem-cell transplantation in terms of extending overall survival times.
Other data showed that Celgene's Revlimid, plus melphalan and prednisone, stopped multiple myeloma from worsening in elderly, newly diagnosed patients. Additionally, Celgene said previously treated multiple myeloma patients who received Revlimid lived a median of 29.6 months, compared with 20.2 months for those only on dexamethasone.
Revlimid is already approved to treat transfusion-dependent anemia stemming from certain types of myelodysplastic syndromes, and it's under Food and Drug Administration review for multiple myeloma. A decision is expected by June 30.
, is looking to treat multiple myeloma with its drug Velcade. Results from a number of trials where Velcade was combined with another treatment have shown some of the highest-recorded response rates, including complete responses, in treating the illness.