Once again they harped on Pain relief and scans. There was definite skepticism expressed by at least 1 analyst surrounding those points. Followed today by a down grade. What's really wanted is proof of PFS. At this time Cabo is all about treating an extremely small population on their last legs. And the extension of life is a mere 11.5 months. The gd. part is they have pain relief, evidently. All the other hoped for treatments Cabo maybe gd. for are a long way off. Until then the income from MTC can only be trivial. There maybe a partner but for MTC it won't mean much to PPS.And if they don't hurry up someone else may come along with a better solution. Leaving Exel out in the cold.
What a bizarre post. Anything over a 4 month improvement in survival would be huge. There is no competition yet for Capo and it is unlikely anyone could start now and beat Capo. We must be patient and stop the hysteria
Dr, that would be cabo. I assume you are using a cell phone and texting is much harder to spell on than a pc.
Yes, patience is a virtue, but the whole roller coaster ride from Nov. '10 to today has been very frustrating to most of us who have been on the ride.
Personally, I can wait, but I don't have to like it. Thanks for your insightful and helpful posts on this MB. I hope you keep posting.
As long as I'm being repentant, I have also said some nasty stuff about oncodoc lately, and if you reading this onco, please forgive my lack of patience and frustration, and I think we are lucky to have knowledgeable posters here like you.
Excuse me. But I disagree and don't think it was bizarre. Also there is competition. For one there is a vaccine that has helped stop breast cancer problems for at least one documented case. There are other drugs in research besides that. What I stated makes sense. We just see this from a diff. point of view. By the way it is not Capo bicycle clothing. It is Cabo short for Cabozantinib.
Hey Kaplan; Agree with all your comments about Cabo. People who don't understand medicine probably should not invest in biotech. Medical experts like yourself recognize Cabo as the coming new superstar in cancer treatment. I think after approval for MTC in late 2012 off-label use will be 100 times use for MTC.
Did not agree with your comment about Provenge. Provenge has a real median life survival of 9-12 months not 4.1 months which is a meaningless number. In one of the great blunders in medical research DNDN gave 72% of the controls frozen Provenge, which turned out to be just as effective as fresh Provenge.
Agree regarding Provenge. The latest updated figures I remember were a bit over 10 months...and these gentlemen were already at death's door. Now the push is on to try Provenge earlier in the disease process, before chemo has all but wrecked their immune systems. BTW, a small subset of Provenge recipients lived over 7 years....that is after they had progressed to very end-stage and were non-responsive to hormones. Provenge achieved this with almost no side effects vs. the terrible side effects of Taxotere. Imagine what might be achieved by Provenge were a booster infusin or two added to the regimen.
Let me clarify a few things about Provenge since I have to prescribe it and give it in one of the largest oncology practices in the NE. It is indicated for minimally symptomatic patients with progression of disease after hormone Rx not for patients "on deaths door." Its approval was based on two trials prolonging survival for 4 months. The drug has not been handled very well. Initially it took my group over 6 months to just get the money back we put out. This has now improved but we are getting few referrals from our urologists for this. I suspect it will pick up but never be a blockbuster. It is not good enough. What is important is that the threshhold for FDA approval for Cabo is low.
Dr Kaplan: You seem to be upset that you "have to prescribe" Provenge? You also state that it "prolongs survival for 4 months" which isn't exactly a fully accurate statement, there are many patients who live a lot longer than 4 months. Yes reimbursement issues have been a problem and it's a lot of $$$ to ask any practitioner to front out of their own pocket not knowing when they will get reimbursed. The whole CMS review ( which IMO ) should never have happened to a FDA approved drug in the first place is largely to blame. DNDN's management has also really dropped the ball in many ways but where do you get off saying Provenge "is not good enough" ? It's well known that the results seen with Provenge put it in an elite class of Oncology products from an efficacy standpoint.
While I too believe Cabo holds much promise and may be a real "game changer" in the future Provenge may also find additional expansion of their label to earlier diagnosed patients pending additional trials.
As a Md shouldn't the welfare of the patient be the primary importance to you? If your in a large teaching hospital setting is "time of reimbursement" the same concern as it would be for a small urologist? It seems as is if your bias for Cabo taints a true coloring of Provenge?
Cabo hopefully will prove itself and have it's place in the treatment course, ( most likely at least initially late stage patients who have failed Provenge first) who knows maybe someday it will prove to surpass and even make obsolete Provenge but till that happens Cabo is just hopefully another tool to help the medical community help patients with Prostate and other forms of cancer.
I would welcome your take on this.
Thank you Dr.K. Extremely valuable to get opinion of treating oncologist. Very clear from Dr. Kaplan's comments that DNDN has done irreparable harm to itself from botched IMPACT study. Giving Provenge to 72% of controls lowered the survival advantage from a spectacular 9-12 months to 4 months which is not enough to get treating doctors to deal with the $96,000 up front payment. Provenge is stuck with the 4.1 number. The IMPACT study now looks like one of the greatest blunders in medical history.
Next Question for Dr. Kaplan.
After Cabo is approved for MTC in late 2012 will you use Cabo off label for metastatic prostate cancer with bone pain.
<<Why do you suppose the "good doctor" made a post telling everyone he has been an oncologist for 36 years on another message board and posts on the EXEL board he has been an oncologist for OVER 40 YEARS? He slipped up....they always do :)>>
Not really. Reread what was written. "involved in..research for 40 years" and oncologist for 36. If you want details email me.
Listen up, "Dr. Kaplan". It's sounds to me like it is YOU who needs to do the math. You clearly stated on another message board you have been an "oncologist" for 36 years. On this board, you tell everyone you have been an oncologist for OVER 40 YEARS. Get real.
...yuzz/newscentral/"doctor kaplan"/ et. al came to this board right after the most recent plunge. Coincidence? Hardly :)
Hedge Fund in full effect here. They are pressing the short side as evident in recent short figures. Interesting times :)
For what it's worth, check this out:
Assuming that it's not a case of identity theft, there is a real-life Dr. Barry Kaplan who has both and MD and PhD and has been a member of ASCO since 1974. You can see his picture on the link I posted. The only caveat I have is that in general the practice of oncology is rather humbling and for an oncologist to proclaim that they are usually right based on the number of years in the field is rather gutsy. In my experience, it's usally safer to bet on the tumor (sad to say). Anyhow, assuming no identity theft issues, it does say something about his belief in Cabo.
Thanks. Assuming he didn't steal the identity is a leap of faith. That's the thing with message boards...you never really know who is behind the keyboard.
EXEL trying to carve out a bottom here but a certain entity clearly wants it lower. The entity who remains short from $12+ will be purchasing those shares at a low price while ringing the register on the massive short side profits along the way. Not a bad trade and EXEL was clearly ripe for the pickin'. GL