BOSTON (TheStreet) --Before we plunge into 2010, let's take a quick look back at the biotech sector in 2009. It was an okay year, certainly not a great one overall. The Nasdaq Biotechnology Index (NBI) closed 2009 up 16%, rebounding nicely off the March lows but still under-performing the broader indices.The healthcare segment of the S&P 500 rose 18% in 2009 compared to the 23.5% gain in the overall index. Biotech's performance was definitely hurt by the lagging returns of the sector's profitable, large-cap components. Only Biogen Idec ( BIIB - Get Report) (12% return in 2009) managed to close higher. Genzyme ( GENZ) was the laggard with a 26% loss for the year. Amgen ( AMGN) closed 2009 down 2%; Gilead Sciences ( GILD - Get Report) lost 15% and Celgene ( CELG) finished flat. The big gains in 2009 came from small-cap biotech stocks, which rebounded strongly from the huge drubbing of 2008. Vanda Pharmaceuticals ( VNDA - Get Report) was the top-performing biotech/drug stock in 2009, returning 2,150% spurred by the surprise approval of the company's schizophrenia drug Fanapt last May. Rounding out the Top 5 best-performing biotech/drug stocks for 2009: Human Genome Sciences ( HGSI) (+1,342%), Keryx Pharmaceuticals ( KERX) (1,034%), Compugen ( CGEN - Get Report) (1,027%) and Opexa Therapeutics ( OPXA) (900%). On the losing side of the ledger, Repros Therapeutics ( RPRX) lost 92% of it value in 2009, stung by drug development setbacks. Other big losers included Star Scientific ( CIGX) (-82%), Sequenom ( SQNM) (-79%), GTC Biotherapeutics ( GTCB) (-77%), and GTX ( GTXI) (-75%).