Blinatumomab has that strong smell of success!! I bought into Micromet in November when blinatumomab came over my horizon. I'm not a professional investor, only a retired paediatrician who for many years worked in a Paediatric Oncology Clinic in the UK in the 1960/70s. The drugs that were used then have hardly changed in today's practice, just one or two new ones essentially as toxic as the old ones and without a startling effect on the cure/survival rate. Yes, it can be fairly easy to get some neoplastic diseases like leukaemias into remission but keeping them there and into a 5-year off-drug survival rate is not easy for the patients (there are always some who die from the treatment rather than the disease) and can leave them with lifelong problems (reduced fertility and the threat of second treatment-induced neoplasms).
But with blinatumomab we are seeing a very different picture in acute lymphoblastic leukaemias.
Firstly, it doesn't seem to be all that toxic - some neurological problems which are reversible and now a cytokine-release problem which can be prevented now that it is known about.
Secondly, it works well where all other treatments have failed, putting roughly 75% of these patients into remission and, remember, it is just these patient's whose disease has defied all current therapy.
Thirdly, and to my mind, perhaps the most significant finding, the post-treatment remissions are very long-lived, just how long is not yet known since the first patients with leukaemia were treated and went into remission about a year ago. Compare that with conventional therapy where relapses in leukaemia off-therapy usually occur within weeks or a few months. This suggests that even after treatment has finished there is an on-going process which is either still suppressing the malignant clone of cells or the malignant clone has been totally eliminated by the 4 week course of therapy.
This final difference accords well with the underlying mechanism of the treatment which is just such a logical way of tackling the disease - identify a (relatively) unique surface marker on the malignant cell and build an antibody which will latch onto it AND onto a surface marker on a Killer T-cell so as to bring the two together. The clinical trials have so far proved the concept and no disasters have been produced. It even looks like the postulate is correct that the "activated" Killer T-cells have the capacity to develop into an ongoing clone of their own so as to "knock off" any of their target malignant cells which may have so far escaped or have developed anew long after the treatment with blinatumomab has been completed. Furthermore, there is no basic reason why this technology cannot be applied to any other malignancy as long as a fairly unique surface marker can be identified and a way found to get the antibody to the target malignancy.
IT ALL SMELLS SO RIGHT!! Forget the money for a moment but if this works, as I now have ever increasing confidence it will, I will be a very happy doctor!!