Biotech Values

[mcbio]

The definition of progression in metastatic prostate cancer incorporates bone-met progression.

You seem to be arguing that treating metastatic prostate cancer per se is somehow different from preventing and treating bone mets, which is like trying to thread a needle that doesn’t exist.

I just listened to EXEL's EORTC call from 11/18/10 where they primarily discussed the Phase 2 XL184 HRPC data. The call is over an hour long. The primary doctor who is involved in the 184 trials was on the call and appeared to draw some distinction between supportive care agents like denosumab and disease-modifying agents like chemotherapy. The doctor believes that 184 is very different from bone-targeted therapies like denosumab for HRPC because denosumab does not result in improvements in bone scan, does not have a dramatic effect on pain, and does not have a measurable impact on soft tissues (whereas 184 is preliminarily showing some activity in these areas). There was also a distinction made between denosumab and 184 in that denosumab inhibits osteoclasts but has minimal effects on osteoblasts whereas 184 inhibits both.

Separately, from EXEL's presentation at Lazard on 11/16/10, the company made the distinction between chemo modestly improving survival in HRPC patients but having little impact on bone disease and bone-targeted therapies like denosumab reducing skeletal morbidity but not impacting cancer progression. All told, from what I gather, EXEL is hoping that 184 combines the benefit of both for a dual effect on the primary tumor (the impact on soft tissues) and on bone metastases (the improvements in bone scans) for, presumably, a potential survival advantage.