Replies to post #15215 on Ariad Pharmaceuticals Inc fka ARIA

[bellweather1]

Thanks for the speculative color Peter!

Best,

bw

[NP1986]

The bigger long-term "threat" - although it would be a very good thing indeed for patients - is that someone figures out a way to combine a TKI (likely ponatinib) with something else and allows patients to go off therapy for extended periods.

They are already testing whether it is "safe" to discontinue Gleevec in patients who achieve a CMR - it is a study being conducted by a French co-operative group, from what I recall. I think if the long-term results show no significant detriment, this strategy could gain traction and it is likely that 2nd and 3rd generation TKIs will be favored over Gleevec. Like you said, it could represent a short-term upside for ponatinib but in the long term would limit the market size.

I think combination treatments are possible, but safety and tolerability are probably going to be a significant barrier to overcome, especially for chronic phase patients. I think we are more likely to see them first being used in refractory patients rather than upfront as a potentially curative treatment.

[gpo344]

"The bigger long-term "threat" - although it would be a very good thing indeed for patients - is that someone figures out a way to combine a TKI (likely ponatinib) with something else and allows patients to go off therapy for extended periods. The good news in that scenario is that pona would likely be the drug of choice in the combination; the bad news (for Ariad, not the patients) is that they wouldn't have to take the drug chronically. In the short run this scenario would perhaps be very good for Aria; in the long run it would reduce the market size considerably."

Peter, that is saying that ponatinib and whatever combination is used would almost be considered a "cure" for CML, in those patients. That would be amazing for those patients and for Ariad. A "cure for cancer" has been the goal of scientists and doctors forever. I wonder what other forms of cancer ponatinib could be used to treat?

Thanks for your amazing insight and contribution to understanding these issues.