Is biotech worthwhile?

Thought provoking BusinessWeek interview with Gary Pisano about pharma/biotech dynamics, particularly saying that biotechs really don’t create value, mostly because they’re “science-based businesses., rather than businesses that do science.

In Pisano's words, the deck is stacked against start-ups as biotechs lack “the scale, the capability, and the experience across the constellation of technologies to do it effectively.” He also says that integrating all of the pieces is impossible for a start-up.

Pisano goes so far as to suggest that stand alone public biotechs will cease to exist, and that biotechs will tend to form deeper relationships but with fewer partners.

Wyeth's Torisel granted priority review

The first mTor inhibitor has been granted priority review. Approval is requested for RCC, which puts it in direct competition with Nexavar and Sutent. As Torisel is fast-tracked, performance is likely impressive and perhaps superior. I wonder if Onyx/Bayer or Pfizer is already talking to Wyeth about conducting combination trials.

14,000 LESS breast cancers incidences in 2003!!!!

This is great news! Breast cancers were reduced by 7% in a very broad sense after the use of hormone therapy was greatly reduced.

I don't think this is old news, as statistics tend to lag events by a few years, so it wasn't really , likely due to reduced

One side effect of this news: the patient population for Herceptin (Erb-b2+) will happily decline slightly. Even with the reduced incidence rate, Genentech and BMS will still have good markets for their targeted products (Herceptin and Tykerb, respectively.)

Akt1-like enzyme to boost immune response?

Per a new Nature Biotech article, scientists have re-engineered Akt1 enzyme to provoke a prolonged immune response to cancer.

This by extension suggests that inhibiting Akt1 has an immune-supressing effect, and perhaps inhibiting other genes in the Akt pathway have the same effect.

Nexavar a dud in melanoma

Best article summarizing the disappointing news that Nexavar did not meaningfully outperform the current standard of care for melanoma. Not sure if this is company spin, or not, but per the article, ONXX is locking in on anti-angiogenic uses of Nexavar, which could be a sign that Nexavar's RAF efficacy is dubious.

Other interesting item from the article: 10% of Nexavar use is off-label.

btw: I'll be out of town for a week starting tomorrow, so no posts likely in the meantime.

Pfizer's pipeline

forbes gives the highlights of Pfizer's pipeline, which includes 3 drugs targeting kinases:

Axitinib - Sutent successor, firstly for RCC, with picomolar potency vs.VEGFR 1, 2 & 3 and nanomolar potency against PDGFR-beta and KIT, which, according to Forbes is "moving soon into final stage trials for thyroid breast and lung cancer."

CP-751871 - IGFR-1 Ab for prostate and lung cancer, now in P2.

CP-690550: JAK3 inhibitor for RA

I'll dig into Pfizer's news to see what else they're touting.....

TT: patient base expands beyond payment capacity?

According to a new report from Decision resources: "targeted cancer therapies are expanding the oncology market by increasing the age limit for treatment....., more than 80% of oncologists say that the availability of targeted cancer therapies is increasing the number of elderly patients who they treat; 64% of these respondents state that the increase is due to fewer side effects associated with targeted agents compared with chemotherapy.

Hmm....time to expand those market projections

But....

Access is an emerging problem:

"Nearly one-fifth of office-based oncologists are planning to limit treatment of Medicare patients in the next 12 months.

Office-based oncologists report that 16% of their Medicare patients who are candidates for targeted therapies fail to undergo treatment for cost- related reasons, most frequently because the patient cannot afford the copayment or coinsurance," said Mary Argent-Katwala, Ph.D., analyst at Decision Resources. "The extent of this problem varies between therapies: oncologists estimate that 10% of eligible patients fail to receive Avastin because patients cannot afford the copayments or because the drug is not available on the formulary for the desired use; for Sutent, the corresponding figure is 52%."

Wow.


2 issues:

Reimbursement: I wonder if the difference in uptake between Sutent and Avastin is largely explained by Avastin's ~15 month earlier FDA approval, meaning that the drug has had enough time to be added to most formularies. (Or is it the difference between options available to treat CRC (Avastin) vs RCC (Sutent.))

Patient opt-out for treatment based on $$$: I'd be real curious to know if this is an example of patient self-rationing (i.e. they don't see a good cost/benefit return for Avastin or Sutent extending life by a few months), or, is this a consequence of American's poor savings habits, as there is interest in treatment, but no cash available?

Interesting reading: next 50 years of science (New Scientist)

Collection of predictions of what the next 50 years might look like (science-wise) from an All-Star team of scientific leaders (from Robert Ballard to Francis Collins to Sydney Brenner.)

ARRY's p38

Courtesy of KinasePro, the link above points to a ~60 slide presentation revealing the development of ARRY's p38 inhibitors (as well as some history of previous p38 inhibitors by VRTX, BI, and Roche.)

Rational DD vs. Trial & error (HTS)

Skewed towards rational DD, there's a few quotes worth repeating:

"Many scientists have realized that blindly screening millions of compounds in the lab and hoping for a hit or a lead is an irrational drug design process that rarely pays off,"

"HTS starts at approximately $1 million per project, with no guarantee you'll find anything useful. "

"Structure-guided design helps to localize subtle features and different conformations in the binding pocket."

"The protein kinases exemplify a family where the potential exists to accelerate lead discovery and optimization by inferring between the massive amount of structural and chemical data from gene family members."

Other takeaways:
AZ is working on CDK4

Gleevec for RA?

Gleevec almost completely prevented the development of the rheumatoid arthritis-like disease in the mice, per Stanford researchers.

Incidentally, good RA summary: "Rheumatoid arthritis is a painful, chronic autoimmune disorder, characterized by inflammation of the lining of the joints. It affects more than 2 million Americans; up to half of those with the disease are disabled after 15 years due to disfigured joints. Standard therapy for rheumatoid arthritis now includes agents that suppress the immune system, but many patients do not benefit from such treatments. They do not get adequate reduction in the symptoms and signs of disease; they may also continue to have damage to their joints or develop side effects that make continued use of such therapies impossible. Thus, new approaches are needed."

Pathway focused discovery

"Signal pathways control a vast range of cellular events and keep cells operating cohesively. Extracellular changes are communicated inside cells via cell-surface receptors, like tyrosine kinase, G-protein coupled receptors, and ion-channel receptors. A signal-receptor complex triggers a cascade of protein interactions." Several companies have novel approaches to discovering drugs through pathway analysis, including:

-Merrimack Pharmaceuticals has developed a computational model of the ErbB receptor network.

-Cellular Genomics' drug discovery platform incorporates several proprietary tools to characterize specific cell signaling pathways. The company is currently targeting several kinases involved in angiogenesis, such as the EphB4 receptor.

Survey of technology facilitating kinase inhibitor development

All from the perspective of service companies not doing proprietary R & D.

Memorable quote:

"The focus on single purified kinase inhibitor screening has lead to poor efficacy in development, because of the ability of tumor cells to compensate and circumvent a block of a single node in the signaling network. Hence, there is a need for a systems biology approach to assay the activity of the signaling pathways downstream of the kinase targets," says Steve Horrigan, Ph.D., interim vp of research at Avalon Pharmaceuticals (www.avalonrx.com).

When added to the problem of genetic mutations, over the long term, can anyone beat the cancer's survival instincts?

Small companies, small molecules

Survey of small molecule DD companies. Especially interesting is Targen, who's efforts are described here (Src and PI-3).

Also interesting is how one company (Biotica) seems to exist to develop derivatives of rapamycin, seeking greater efficacy and stability.

Bio business food chain in action

General article detailing the well-known trend of big pharma buying small to mid biotech.

Stats that justifies the blog posting:

"the average biotech take-out premium has jumped to 62 percent this year from an average of 49 percent over the past eight years."

"average returns from trade sales are now around 2-1/2 times higher than those from IPOs."

Interestingly, the article highlights two deal examples that have totally contradictory rationale: Shire - definitely a products company vs. Sirna, which seems to me to be more of an enabling technology company (or perhaps even an IP play.)

ALL therapies: +12% for next 9 years

Decision Resources expects robust growth thru 2015, based on STI approvals.

Also, I didn't realize it, but NVS' Gleevec successor is now dubbed "Tasigna." I wonder why they didn't build off the Gleevec recognition? (Gleesigna?)

Clinical data for Tasigna looks great, per the press releases.

Separately, NVS has announced an intent to file for Tasigna approval before the end of the year.

Lilly: postive P3 Arxxant results

I don't know how I missed this one:

Last week, Lilly released information on Arxxant - a oral small molecule PKC-beta inhibitor. The data look positive: Arxxant patients were about half as likely to have deteriorated vision due to diabetes complications than placebo patients. No toxicity was reported.

PKC - beta has been linked to blood vessel damage to the nerves, eyes, and kidneys of diabetes patients. The application under trial was diabtes retinopathy, a disease affecting ~4M Americans.

Analyst estimates for peak Arxxant sales (in 2010) range from $200M to $650M.

I don't know Lilly's target revenue per patient, but if the US market represents half of the world market (we're fatter), it seems like peak sales are likely to be higher given a modest price and assuming continuous, chronic dosing (i.e. an accumulating patient base - similar to the Gleevec effect.)

Targeted Cancer Drugs May Work By Disrupting Balance Of Cellular Signals

Harvard article that attempts to explain (in general) how kinase inhibition can fight cancer. The novelty here is that the theory introduced would explain why targeted drugs have not worked well in combination with chemotherapy drugs.

Are EGFR Inhibitors Only Useful in Certain Patient Groups?

It's becoming more clear that some targeted therapies can be even more finely targeted, as highlighted in this summary of EGFR inhibitors.

Consider these findings from Iressa trials:
"EGFR inhibition response rate to Iressa was 27% in Japanese patients compared with only 10% in non-Japanese patients, but that this difference was not as significant as the differences in response rate favoring women over men, patients with adenocarcinomas over squamous carcinomas, and healthier patients over less healthy ones (“performance status”, or the ability to perform the activities of daily living without assistance or significant symptoms). The US-based IDEAL-2 trial also showed women receiving iressa to be more likely to have symptomatic improvement (50% vs. 31%) and significant tumor shrinkage (19% vs. 3%) compared with men, and also that patients with adenocarcinomas were more likely to have symptomatic improvement (43% vs. 30%) and tumor shrinkage (13% vs. 4%) compared with those who had squamous tumors. "

Good news (in terms of tumor shrinkage, but NOT survival) if you're a non-smoking Japanese woman with an adenocarcinoma, bad news if not.

Kind of amazing that this sort of knowledge is only coming to light ~3 years post-FDA approval. (I'm not suggesting that approval be delayed, just that with any approval, there's still many important outstanding questions.)

This also brings to mind the question of who is likely to sponsor the development of the relevant intelligence and diagnostics to further segment patients. You might guess that the makers of EGFR inhibitors would, but is it in their best interest to EXCLUDE potential customers? (Plus, there's enough competitors among EGFR inhibitors that no one is likely to want to pay to develop this market for the benefit of their competition.

(That being said, I'm pretty sure that I've seen press releases announcing that AZ has sponsored EGFR biomarker development, with CST, I think.)

UPDATE: Tykerb

Better article on the FDA news, plus a projection that the drug's peak revenue could be $4B!

Tykerb: $2B in rev @ peak?

GSK's Tykerb just received priority FDA review, meaning that if everything goes right, it will be on the market in about 6 months - initially for breast cancer.

The linked article suggests Tykerb will peak at $2B in annual revenue, which seems a bit large.

A small molecule dual EGFR + Her2/neu inhibitor, Tykerb could supplant Herceptin (~$750M in 2005 sales) and potentially Tarceva, meaning that Genentech is solidly in GSK's cross hairs (not to mention other EGFR product makes like ImClone/BMS, and Amgen.)

IMHO, DNA needs to rev up Tarceva marketing ASAP.

This time anti-inflammatory has anti-cancer effect

I didn't go looking for this theme, but funny enough my first article today is a mirror image of yesterday's last article......

Researchers at Ohio State have developed a new oncology therapeutic derived from the same chemical structure as Celebrex, which was previously noted to have an anti-cancer effect. The derivative compound (lead: OSU-03012) shares lineage with other COX-2 inhibitors.

It turns out the new compound and Celebrex inhibit Akt, which has long been a target of interest for pharma. (I don't know why prior Akt efforts have failed - was it toxicity? If, watch interest in Akt ramp up with the identification of safe Akt inhibitors based on COX-2 inhibitors.)

Cancer kinase inhibitors for hypertension too?

Researchers believe that Nexavar (competitor to Sutent) may prevent pulmonary hypertension, in addition to its’ anti-cancer properties. (The article doesn’t state which target Nexavar blocks to counter hypertension.)

It’s been long talked about that cancer and inflammation are linked diseases, with some even suggesting that they’re the same disease (and managed by IKK kinase), so the Nexavar finding isn’t shocking, but it’s most important implication may be an extended application for this class of drug.

In spite of this news, stock in Onyx (Nexavar's maker) dropped 1.8%. I still think Onyx is a buy, as I detailed here:

http://cogentpassion.blogspot.com/2006/06/i-bought-onxx-onyx-pharm.html

Tarceva in the news

Pricing to rise slightly.

The news that DNA is raising Tarceva pricing is interesting given that about a month ago, Genentech (DNA) announced a cap on per patient costs for Avastin, especially since both medicines are anti-angiogenic solid tumor fighters (though targeting different genes.)

There's probably 2 reasons for the difference:

1) Avastin is a monoclonal antibody, and much more expensive to produce.
2) Avastin is wholly owned by DNA, while Tarceva is partnered with OSI. OSI probably doesn't need to send the same social message that DNA does, and therefore is not as interested in capping costs. Or, OSI wants to raise prices to increase Tarceva's profile within DNA (and hence profitability).

(It's pretty clear that DNA is pushing Avastin harder than Tarceva. I'll illustrate this in a future post. Tarceva may be the better product in the long run, strictly due to patient compliance costs in consuming a small molecule (pill) versus weekly injections (Avastin.)

It's still hard to accept why OSI and DNA are both partners and competitors in this space and wonder how long this will last - with either DNA buying OSI, OSI buying out of the DNA agreement.

OSI has small molecules in development that could/would supplant Avastin, but they're years away


Somewhat related: NICE (UK health cost/benefit agency) just determined that Tarceva is not cost effective, and is therefore not available in England as part of NHS (public) medical care. Tarceva is, however, covered by the NHS in Scotland.

The decision isn't final, though.

This brings up a deep moral question. I guess I shouldn't be shocked that Britain has coldly run the numbers on Tarceva, and are willing (and able) to tell people who could benefit from Tarceva that the government doesn't find their additional time on this Earth, or improved quality of life to be a good investment.

Story: NICE gives thumbs down to Tarceva

MP-529 (Supergen)

Supergen (SUPG) provided an update on MP-529, a very selective Aurora A inhibitor. In addition to MP-529, Supergen also revealed data pertaining to a an Axl inhibitor (SGI-AXL-277), and Pim and Plk inhibitors.

SUPG has an interesting selection of targets. Pim, Plk, and Axl aren't yet of wide interest, meaning that SUPG is taking on enormous target biology risk in addition to the native chemistry/drug development risk.

SUPG is valued at ~$275M, with cash on hand of ~$75M.

Handicapping targeted drugs

Though not the main conclusion, this article suggests that dasatanib may be an even better therapy than gleevec for CML patients because dasatanib also inhibits Src signaling in addition to Bcr-Abl.

If so, from a business perspective, BMS just became a bit more valuable. Analysts predict annual sales of $500M for dasatanib (Sprycel), but it if this article is right, may be more like Gleevec's $2.2B annual revenue.

Does this suggest a Novartis buy-out of BMS?

BMS is trading at $24.50.

CYC116

Cyclacel - which has a CDK inhibitor in P2 - also revealed that their Aurora inhibitor is near IND (CYC116). What's interesting, though, is that in this article (http://biz.yahoo.com/bw/061113/20061113005486.html?.v=1) Cyclacel reveals (I think for the first time) that CYC116 not only inhibits Aurora, but also VEGFR2. This could be a case of limited selectivity being spun as a positive, but if CYC116 is selective for just Aurora and VEGFR2, you'd have an anti-angiogenic cell cycle inhibitor, which would be very interesting, if effective.

Note, Cyclacel also said CYC116 was just about to IND this time last year, and while CYCC has ~$60M in cash on hand, the company's market value is only ~$90M

Kinase drug discovery 101

This somewhat dated excerpt of an interview with a scientist at Array (ARRY) gives a good background in kinase drug discovery and rationale for such efforts.

BI touts new multi-TK inhibitors

BI takes the wraps off 3 programs:
BIBF-1120 - targeting VEGFR, FGFR, and PDGFR
BIBW-2992 - targeting EGFR and Her-2
BI-2536 - targeting Plk-1

What I found interesting about the announcement:

-BI comes VERY close to saying that all 3 are in Phase II trials. But not quite. It really looks (after a database search) like only BIBF-1120 is actually in phase II.
-BIBF-1120 does not appear to also target Kit or (likely) Flt-3, which multi-TK inhibitors often do. This might be by design, or just something that BI isn't willing to disclose.
-This is the first Plk-1 compound in clinical development (that I'm aware of).
-No Src inhibitors under development - is that due to lack of interest, or discovery success?
-it is now stacking up that every serious pharma has (at least) two anti-angiogenic multi-TK compounds in development. Typically, one targets VEGFR (and associated receptors (most frequently PDGFR)), and the other targets EGFR.

BI is firmly in the race!

PI3 summary

Great summary article on the merits of PI3 gamma as a drug target in many indications.

Nexavar vs. Sutent

Onyx just posted 3Q results. Nexavar sales rose 41% to $45M for the quarter versus $63M and 75% growth by Sutent over the same period. (Pfizer also notes 7,500 Sutent patients vs. 6,000 last quarter.)

It's probably too early to declare a winner (the winner may be determined by who does the best, quickest job expanding the label), but Sutent (Pfizer) almost doubled Onyx/Bayer's new revenue for the quarter.

I suspect that Onyx stock may take a hit based on the comparison to Sutent, but these figures actually put Onyx on track to surpass '06 Nexavar sales. A good 4th quarter with 33% growth to $59M would put Nexavar '06 sales in excess of $160M. I'm pretty sure that consensus estimates were around $140M.

Sutent results really look strong, especially considering that Pfizer has a not-yet-mature oncology sales force.

Proposal to reduce GMP requirement for P1 trials drugs

This rule change would reduce by a few million dollars the cost of producing a drug for initial safety trials. This would, however, INCREASE the safety risk (slightly). I guess the clinical folks feel good about non-GMP manufacturing processes.

Company with PI-3 compound under development sold

Small deal, with most of the value being NON-PI-3.

Ambit + Cephalon= $250M

Cephalon is paying Ambit to access Ambit's Kinome Scan and initiate and advance 2 novel kinase programs. $18M paid up front, $232M in potential milestones, spread across 2 programs, beginning at time zero (discovery, as the targets appear to have been selected already.)

Simple math says average $9M upfront and $116M in potential milestones per program, though it's probably safe to assume that ~$2M-$5M in cash is to cover Ambit's contract screening. The result is a slightly below market bounty per program for Ambit, but this could easily be offset by a contribution of effort by Cephalon to the development of the 2 programs.

AMG 706: not so hot

According to a Merrill Lynch analyst, AMG 706 appears to be neither as safe or as efficacious as Sutent. The key data in his conclusion: 3% patient response for AMG 706 vs. 7% response in P3 Sutent trials.

One thing to keep in mind: all trials data relates to GIST, which is probably not the target market for AMG 706 (or Sutent, for that matter.)

AMG 706 news

First disclosure of P2 results from Amgen's small molecule multi-TK inhibitor, targeting all VEFRs, PDGF, and Kit. Interesting to see that the first indication is (was?) Gleevec-resistant GIST., so it would seem that the Kit targeting is the first (best?) application.

Other interesting details:
-daily dosing, so little tox worries.
-125mg dose - seems large, indicating reduced potency?
-still only about a third of all patients demonstrated a clinical response.
-pretty high rate of adverse reactions (nausea, hypertensions,etc.) affecting it would seem nearly all participants.
-explicit mention of further inications/trials (NSCLC and breat, in particular) and monotherapy targeting of medullary thyroid cancer, which has no effective treatment.

IN all, AMG 706 sounds like a very competitive product.

Exelexis suspends XL999 P2 trials

EXEL suspended enrollment of patients in the Phase II cancer program for XL999 after a preliminary review showed four out of 14 patients enrolled during October experienced serious adverse cardiovascular events. EXEL said 12 out of 117 patients had experienced serious cardiovascular events through the end of September. Because all but one of the events occurred on first administration, EXEL is continuing to treat the patients already enrolled in the trial. To date, 115 of the 131 patients enrolled have received repeated doses with no cardiac toxicities. Dosing has been every week or every other week, ranging from two doses (two weeks) to 53 doses (about two years). EXEL expects enrollment to be suspended for two weeks to three months while it reviews data. XL999 is a spectrum selective inhibitor of VEGF, FGF and platelet derived growth factor (PDGF) receptors and FMS-like tyrosine kinase 3 (FLT3). On Thursday, EXEL fell $1.13 (12%) to $8.21.

Citation for level of pharma kinase activity

According to Frost and Sullivan, the pharmaceutical industry spends nearly one third of its $50 billion of research and development dollars on kinase inhibitor therapeutics. Kinases are a class of proteins which are known to signal certain illnesses, including some cancers, to the "on" or diseased state. Kinase inhibitors effectively can turn the "on" signal to an "off" state. Interest in this area has been propelled by the success of Gleevec, a multibillion drug from Novartis which was the first approved drug to directly turn off the signal of a protein known to cause a cancer.

Array Pharma advances p38 lead to clinic

Array just completed an IND for ARRY-797, and expects to launch safety trials as a precursor to RA application trials.

TAK1 - key activator of AMPK signaling?

One target first put forth by a Scottish academic a year ago is TAK1, though the academic mentioned it in respect to inflammatory response. A recent paper from the Baylor College of Medicine describes suggests TAK1 might be an interesting target for diabetes, as it appears that this is what metformin affects.

VEGFR for non-cancer vascular applications?

VEGF receptor promotes optical clarity
Researchers from the Medical College of Georgia and colleagues published in Nature that soluble VEGF receptor 1 promoted avascularity and optical clarity in the cornea of mice by serving as a "trap" for VEGF-A, a stimulator of angiogenesis. They believe soluble VEGF receptor 1 (also known as soluble FLT1) can be used to prevent or treat neovascularization, and they said it may serve as a target for inducing angiogenesis for pre-eclampsia, wound healing, stroke and heart disease.

Gleevec wins expanded approval

dermatofibrosarcoma protuberans,
relapsed/refractory Ph+ ALL,
certain forms of myelodysplastic/myeloproliferative diseases,
hypereosinophilic syndrome/chronic eosinophilic leukemia, and
aggressive systemic mastocytosis.

Average clinical trial costs

Phase I: $15,700/patient
Phase II: $19,300/patient
Phase III: $26,000/patient

Another big TK inhibitor deal

Bayer & Regeneron.
$75M upfront.
$245M in potential downstream payments. ($40M for phase 3 initiation, $70M for marketing approval, $135M in sales milestones beginning at $200M in annual sales.)
Shared development expenses.
Shared ex-US profits.
For ex-US rights to a phase II compound targeting an indication that there's already one approved remedy (Macugen) and another pending (Lucentis.)

Met TK linked to autism

treatment for EGFR skin rashes

Interesting apporach to treating EGFR inhibitor caused skin rashes. While the EGFR inhibitor is prescribed for an internal solid tumor, this company seeks to treat the skin rashes by topically applying a phosphatse to initiate more EGFR signaling on the skin.

Leonard Saltz on targeted therapies

Article mainly focused on cost of these cancer drugs.

CGI-Genentech

$25M upfront (mix of license and equity)
>$500M in downstream potential
This deal addresses a SINGLE target with multiple indications!

Roche-Plexxikon B-Raf deal

$40M upfront
$6M in annual R & D funding
$660M in downstream potential
Compound not yet in the clinic

PIramed-Genentech

Aggregate value of $230M; undisclosed upfront

2010: kinases $58B annually (Pharmaprojects)

According to a new report, the kinase-targeted drug market is set to grow from $12.7 bn (€10bn) in 2005 to $58.6bn in 2010. Cancer (mainly solid tumours) is expected to remain the dominant application throughout the forecast period.

EGFR market....

...is $3B. (2005):
In 2005, the four major marketed drugs targeting the EGFr pathway, trastuzumab (Herceptin; Genentech), cetuximab (Erbitux; ImClone Systems); erlotinib (Tarceva; OSI Pharmaceuticals), and the now withdrawn gefitinib (Iressa; AstraZeneca), generated worldwide sales of more than $3 billion. The recent entry of panitumumab (Vectibix; Amgen) into the USA market and the possible approval of Tykerb, create new challenges in clinical use and marketing of these agents.

Oncology Drug Development Update - Targeting the Epidermal Growth Factor Receptor (EGFr) Signal Transduction Pathway: "In 2005, the four major marketed drugs targeting the EGFr pathway, trastuzumab (Herceptin; Genentech), cetuximab (Erbitux; ImClone Systems); erlotinib (Tarceva; OSI Pharmaceuticals), and the now withdrawn gefitinib (Iressa; AstraZeneca), generated worldwide sales of more than $3 billion. The recent entry of panitumumab (Vectibix; Amgen) into the USA market and the possible approval of Tykerb, create new challenges in clinical use and marketing of these agents."

Dual Drug Approach Gives Reason to Cheer

NVS researcher uses p38 inhibitor to "manage" the degeneration of heart muscle.

Dual Drug Approach Gives Reason to Cheer