Ariad Pharmaceuticals Inc fka ARIA

[biomaven0]

combo of Tarceva with AP26113

Makes no real sense. Right now they will go after 2nd line EGFR - patients that have already failed Tarceva. But this isn't a slam-dunk in my view - it could work great or have only marginal activity given the other drugs that are active against this mutation have been very disappointing. So I think of it as having tremendous potential, but we really need for it to be in the clinic to see what the outcome will be.

By contrast, assuming no unexpected toxicity, I am pretty confident that it has a good chance of working in Crizotinib failures.

In terms of front line, when the drug gets approved there will still be no evidence of its long term efficacy or tolerability. That, plus Gleevec with its long record of safety and efficacy and about-to-be-generic status will keep the vast majority of oncologists using Gleevec as front line. A few leading-edge oncologists might use it, but absent some actual trials it's not going to get much front line usage. I assume they will price it on par with the other 2nd-line agents, so it will be about 50% more expensive than non-generic Gleevec. So there would almost certainly be considerable resistance from payors to using it off-label in front line.

I still think the smart trial to do is high-risk front line patients up against Gleevec.

Peter