[Ip-health] NYT: New Drugs for Cancer Could Soon Flood Market

[Amy Nunn]

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New Drugs for Cancer Could Soon Flood Market


By ANDREW POLLACK
<http://topics.nytimes.com/top/reference/timestopics/people/p/andrew_pollack
/index.html?inline=nyt-per>

Published: June 5, 2006

ATLANTA, June 4 - Big Pharma has discovered cancer
<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics
/cancer/index.html?inline=nyt-classifier> .

For several years biotechnology companies like Genentech
<http://www.nytimes.com/redirect/marketwatch/redirect.ctx?MW=http://custom.m
arketwatch.com/custom/nyt-com/html-companyprofile.asp&symb=DNA>  and ImClone
<http://www.nytimes.com/redirect/marketwatch/redirect.ctx?MW=http://custom.m
arketwatch.com/custom/nyt-com/html-companyprofile.asp&symb=IMCL>  have
garnered most of the attention at the nation's largest cancer meeting with
new so-called targeted drugs that were in general less toxic than
traditional chemotherapy
<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics
/chemotherapy/index.html?inline=nyt-classifier> .

But this year, the most significant data on targeted drugs is coming from
the traditional big pharmaceutical companies.

Doctors at the American Society of Clinical Oncology meeting here said
Sunday that temsirolimus, an experimental drug from Wyeth
<http://www.nytimes.com/redirect/marketwatch/redirect.ctx?MW=http://custom.m
arketwatch.com/custom/nyt-com/html-companyprofile.asp&symb=WYE> , prolonged
lives in very sick kidney cancer patients by about three and a half months,
a finding that could pave the way for the drug's approval next year. And new
data on Pfizer's
<http://www.nytimes.com/redirect/marketwatch/redirect.ctx?MW=http://custom.m
arketwatch.com/custom/nyt-com/html-companyprofile.asp&symb=PFE>  Sutent
could make that drug, which is already on the market, the first choice for
treating kidney cancer.

A day earlier, GlaxoSmithKline's
<http://www.nytimes.com/redirect/marketwatch/redirect.ctx?MW=http://custom.m
arketwatch.com/custom/nyt-com/html-companyprofile.asp&symb=GSK>  breast
cancer
<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics
/breastcancer/index.html?inline=nyt-classifier>  drug Tykerb was the center
of attention.

Neither Glaxo, Pfizer nor Wyeth had much of a presence in the cancer
business several years ago. But pharmaceutical companies have awakened to
the scientific discoveries and business factors - particularly high prices -
that have transformed an area they once considered more of a niche market.

But the new scramble into cancer could result in a flood of "me-too" drugs.
Numerous pharmaceutical and biotechnology companies are developing drugs
that seek to choke off the flow of blood to tumors
<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics
/tumors/index.html?inline=nyt-classifier>  or interfere with proteins inside
the tumor that spur it to grow.

"We're all going to have to have flash cards to remember all the names of
these agents in the future," Dr. Hope S. Rugo of the University of
<http://topics.nytimes.com/top/reference/timestopics/organizations/u/univers
ity_of_california/index.html?inline=nyt-org>  California, San Francisco,
said after presenting a lecture on sunitinib, axitinib, sorafenib, pazopanib
and other similar-acting and similar-sounding drugs.

About 400 cancer drugs from 178 companies are in clinical trials, according
to the Pharmaceutical Research and Manufacturers Association. That is twice
the number of drugs in trials for illnesses like Alzheimer's
<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics
/alzheimers/index.html?inline=nyt-classifier>  disease and depression
<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics
/depression/index.html?inline=nyt-classifier>  and nearly three times as
many as for heart attack and stroke.

For patients, the flood of drugs is generally good news because it means a
better chance of finding one, or a combination, that will work for them.
"From the standpoint of the patients there is never too many," said Dr.
Robert J. Motzer, a kidney cancer specialist at Memorial Sloan-Kettering
Cancer Center in New York City.

Increased competition could also mean that drug companies will put more
effort into reducing side effects. In the past, it was considered acceptable
for drugs to have noxious side effects because cancer was a fatal disease.

But for the companies, the competition could mean smaller markets for each
drug and costlier clinical trials to differentiate a product from its
competitors. Competition could also bring down prices, which are now
reaching $100,000 a year for some cancer drugs, though overall costs to
patients might rise as more drugs are used in combination.

Analysts at Merrill Lynch recently estimated that the market for cancer
drugs would double to $50 billion a year in 2010, from $25 billion now. But
because of increased competition, the sales potential for each drug would
fall 21 percent to 32 percent by then. For many types of cancer, the
analysts said, the number of drugs in the final phase of clinical trials
exceeds the number already on the market.

To be sure, some big drug companies, such as Bristol-Myers Squibb
<http://www.nytimes.com/redirect/marketwatch/redirect.ctx?MW=http://custom.m
arketwatch.com/custom/nyt-com/html-companyprofile.asp&symb=BMY> , have long
been involved in cancer drugs. And one of the earliest and most successful
of the new targeted therapies, Gleevec, was developed by Novartis
<http://www.nytimes.com/redirect/marketwatch/redirect.ctx?MW=http://custom.m
arketwatch.com/custom/nyt-com/html-companyprofile.asp&symb=NVS> .

But many other companies preferred making drugs for chronic diseases to
treatments for cancer, where patients often die within months. Also while
cancer as a whole affects many people, the market is divided into different
types of cancer.

But companies have discovered that some patients will tolerate prices of
tens of thousands of dollars a year, making drugs for even rare cancers into
big moneymakers. Gleevec, which is used primarily for two obscure cancers -
chronic myelogenous leukemia
<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics
/leukemia/index.html?inline=nyt-classifier>  and gastrointestinal stromal
tumor - had sales last year of $2.2 billion.

Some of the newer drugs are pills, playing to pharmaceutical industry's
strength in chemistry. And cancer is becoming, in some cases, a chronic
disease.

An update presented here of an early clinical trial of Gleevec found that 90
percent of the people who took the drug were still alive after five years.
Typically, about half of people with chronic myelogenous leukemia would have
died within five years of diagnosis.

Yet the disease is controlled, not cured. If the patients stop taking their
daily Gleevec pills, the leukemia generally comes back.

Yet another factor is that genetic studies are finding many potential ways
to attack cancer. For some other diseases, like Alzheimer's, it is not as
clear how to attack.

Some of these factors can be seen at work in kidney cancer. While not one of
the most common cancers - there are fewer than 40,000 new cases a year in
the United States - it has become a hotbed of activity. Traditional
chemotherapy has not worked well for kidney cancer, so until recently the
main treatments were two biotech drugs, alpha interferon and interleukin 2,
which are barely effective and extremely toxic.

But two pills - Sutent from Pfizer and Nexavar, developed by Bayer
<http://www.nytimes.com/redirect/marketwatch/redirect.ctx?MW=http://custom.m
arketwatch.com/custom/nyt-com/html-companyprofile.asp&symb=BAY>  and Onyx
Pharmaceuticals - have been approved in recent months. Both drugs work in
part by blocking a protein that spurs the formation of blood vessels that
nourish tumors.

Genentech proved that the approach worked with Avastin, its blockbuster
colon cancer drug. And kidney tumors depend to an unusually high degree on
that protein, so many companies are testing their drugs in kidney cancer.

On Sunday, Pfizer seemed to get the edge on its rivals with data showing
Sutent superior to alpha interferon as an initial treatment for advanced
kidney cancer, as opposed to treatment after another drug had failed. The
median time before cancer worsened was 11 months for Sutent, in contrast to
5 months for interferon. Since Bayer and Onyx do not have comparable data
yet for Nexavar, Sutent might become the preferred initial treatment.

Wyeth's temsirolimus blocks a different tumor growth-promoting molecule
called mTOR. In a late-stage clinical trial, those who got the Wyeth drug
lived a median of 10.9 months, in contrast to 7.3 months for interferon. The
patients in the trial had a poorer prognosis from the outset than those in
the Sutent trial, making it difficult to compare the two drugs.

The presence of the big pharmaceutical companies here is "a bit of a wakeup
call for biotech companies and investors," said Geoffrey C. Porges,
biotechnology analyst at the financial research firm Sanford C. Bernstein &
Company.

Genentech, the pioneering biotech company, faces the most attacks because it
is the most successful developer of targeted cancer drugs. Its breast cancer
drug Herceptin will be challenged by the new Glaxo drug, Tykerb. And Avastin
could face many challengers. Many of the newer competitors are pills, while
Herceptin and Avastin require infusions.

But the competition probably will not hit in full force for a few more
years, and Genentech is not standing still. It is testing Avastin, which is
already approved for colon cancer and has been shown to work in lung and
breast cancer, in numerous other types of cancer. It is also trying to come
up with new drugs.

One hope, though it is still in early trials, is a drug being co-developed
with a rival, Amgen
<http://www.nytimes.com/redirect/marketwatch/redirect.ctx?MW=http://custom.m
arketwatch.com/custom/nyt-com/html-companyprofile.asp&symb=AMGN> , that
induces cancer cells to self-destruct, a process called apoptosis.

"We need to create another bandwagon," said Dr. Susan Desmond-Hellmann,
Genentech's president for product development.



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