SurModics Inc (SRDX)

[Democritus_of_Abdera]

If not triamcinolone, then perhaps Gleevec...

I would like to see the I-vation platform used to deliver a small molecule adjuvant during Lucentis treatment of wet Age Related Macular Degeneration (ARMD). My hopes have been pinned on triamcinolone being used in this manner... and there are some clinical trials related to this possibility... but they are with avastin rather than Lucentis.... for example see: http://www.clinicaltrials.gov/ct/show/NCT00376701?order=4

I’ve noticed that Genetech is initiating a clinical Phase I trial exploring the use of Gleevec (Novartis) as an adjuvant to Lucentis.... see: http://www.clinicaltrials.gov/ct/show/NCT00403156?order=11

This strikes me as an important initiative. I expect we will soon hear that renewed macular degeneration rapidly returns after Lucentis treatment stops due to rapid revascularization. The reason being that the infrastructure layed down to support the neovascularization of ARMD (vascular sheaths and pericytes) is not disassembled by VEGF inhibition. Gleevec treatment, on the other hand, detaches the new pericytes removing an essential element needed for revascularization (Bergers et al., J Clin Invest 111:1287, 2003).

In their clinical trial, Genentech is giving the Gleevec systemically (a daily pill of 400 mg over several months). Gleevec, however, has side affects ( http://www.gleevec.com/info/page/safety_info ). These side-effects are tolerated by a patient fighting cancer, but might affect compliance by those with ARMD. The side effects could be avoided if the I-vation platform was used. I view this as a lost opportunity.