Replies to post #115135 on Biotech Values

[zipjet]

iwfal & dewophile,

I want to thank each of you for elucidating some of the issues around Cabo. I am sure I don't fully understand but at least I am now aware of some of the difficulties.

If I had the questions and understanding of iwfal, I would try and talk to one of the investigators and see if they could move my understanding forward.

My primary interest at this time is as an investor. I agree with Peter's comments on the optimistic path to approval:

http://investorshub.advfn.com/boards/read_msg.aspx?message_id=60091563

The view I took early and still hold is that Cabo exhibits a drug effect so dramatic, so large, that there is a significant probability (over 20%) that EXEL and the FDA will find a way to move Cabo quickly into the market.

That possibility was not and still is not reflected in the stock price. The market continues to value EXEL as if Cabo will follow a relatively normal path to market.

ij

[biomaven0]

Yes, it is possible that the drug is somehow blocking the osteoblastic pathway - that would mean that bone mets would not progress (or show up on these scans), but also that existing bone mets would not heal. Most prostate bone mets are osteoblastic in nature (breast ca mets tend to be more mixed).

Just how complex these pathways are can be seen in this article about the interaction of PSA and bone:

Does Prostate-Specific Antigen Contribute to Bone Metastases?

http://clincancerres.aacrjournals.org/content/12/5/1395.full

This article about breast ca bone mets also is helpful as it relates to the different scanning methods available:

http://www.aboutcancer.com/bone_mets_pet_807.htm

Fusion of Metabolic Function and Morphology: Sequential [18F]Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography Studies Yield New Insights Into the Natural History of Bone Metastases in Breast Cancer

It would be interesting to see some [18F]FDG-PET/CT scans of these patients - that might clear things up some. Also necropsies of their animal model would be informative.

Peter