Biotech Values

[dewophile]

zgen
hi tony
i just did a quick search - interferon lambda is definitely expressed by several immune system cell species (cd4, dendritic cells). The primary tissues which don't express IN-L receptors and account for many of the SEs of IN alpha are brain (fever, fatigue, depression) and bone marrow (myelosuppression). But your point is well taken - the direct antiviral effects in the liver may be identical to IN-alpha, but will effects on adaptive immunity differ somewhat from IN-alpha? perhaps. taking it one step farther, perhpas I am wrong altogether and immunomodulation is not that important, and with rapid clearance of virus using direct antivirals alone, an immunocompetent patient's immune system will then kick into gear and roles of IN and ribavirin in adaptive immunity will be less consequential. So just to think through such an excercise, say combiation protease and polymerase therapy yeilds a high enough barrier to resistance that 90% of patients who complete therapy are PCR negative at end of treatment, and say relapse is low if the patients immune system is now freed so to speak to maintain durable response without immunomodulation - lets say there is a 10% relapse rate. lets also say dropout is low (5%) and adherence to the regimen is high (95%). I think if you add it all up success reaches 75%. lets say its 80%. what would retreatment options then be for the patient who fails the all-oral cocktail of direct antivirals (and who presumably now harbors resistant strain). Interferon! so if interferon in 5-10 years is relegated to second line treatment what do the commercial prospects look like? i would argue 20-25% of the hep c population of failures to first line still represents a serious commercial opportunity, especially if IN-lambda becomes the IN of choice.

I am sure when pharmas (who are already at the negotiating table apparently) are evaluating the present value of the candidate, in addition of course to its chance of success based on data to date and the competitive landscape, are factoring in the likelihood of direct antivirals supplanting IN as first line, and the timeline in which this might happen. But i still see the drug getting partnered for big money if data are strong