Personally, I think Ruxo will eventually get a lot of use for PaCa. But it is unlikely to be financially important until after the p3s report. A subgroup defined by modified Glasgow score looks to a lot of oncologists like a subgroup defined by alphabetical order. Results that WEREN'T defined endpoints (general wellness/illness) may dominate the post-presentation talk.
I'm not shocked. This modified Glasgow score is a pretty slippery item. I can't say what keeping mum about it to the very last instant did for the competitive situation, but it created a sort of sick focus on what defined the subgroup, and increased stock volatility. As far as a correlation between the 2 approaches, we already know that they are doing a clinical trial based on a guess that it works that way. I'd personally be very cautious about saying anything ahead of that result.
I just don't want a repeat of August '12.
I bought Incyte 5 years ago for $8.17. My calculator show that as a 43% annual yield. How's that for a number?
Guys who direct big money think of ITMN as the toy of SAC capital when they think of it at all. Most manipulated stock in the general NASDAQ. They do some DD and see the boom/crash history, maybe see the unfortunate history of Harkonen and his mouth.
What it comes down to is that love (and buying interest) won't automatically be given to this stock. The market is permanently in "show me" mode for ITMN.
Hy's law says that if a drug is shown to cause a certain signal, it is capable of causing liver failure. The highest rate of liver failure consistent with clinical experience would be tolerable, even irrelevant, set against the benefits of Pirfenidone. You don't ignore it, but it doesn't rate center ring.
The big issue this weekend is tolerability. Incyte has demonstrated in the field that Esbriet can be tolerated, but the inconvenience is pretty high. The tweets suggested that the BI drug was dramatically more tolerable, but when the abstract was released it didn't look so great. Intermune will have presentations bearing on whether tolerability of Pirfenidone or analogs can be improved.
The ONLY way you can get a $14 price target for Incyte is by assuming incompetent management who will drive the company hard into disastrous actions at the first failure of their over-optimistic plans. After all, these are mostly scientists, not businesspeople.
You can make a strong case that the stated development program over-commits the company's resources. But you can make just as strong a case that management have a very good appreciation of the constraints they are under. I keep reminding people of the refinancing that permitted Ruxo to reach market: A dilutive convert sale put Incyte in a strong enough position to get very good collaboration agreements with Novartis and Lilly. Basically, the "business as a second language" gang bargained the pants off the finance professionals.
Will the gifted amateurs do it again? Did they do it again already in the convertible rollover? HH spilled [some of] the beans in the Q&A of the BoA/ML call, He said Incyte was excited about several programs, announced and unannounced, but resources were being channeled to the JAK inhibition programs and to immunologic checkpoint inhibition. Eyes bigger than the stomach, yes, but no evidence of a lack of self-control.
Bust just seems insane. There IS a level of success short of the moon: The US Jakafi for MF business is growing like it can at least double from here. If things that are presently hoped for go bad, there's a real possibility of financing through collaborations.
I think there was some hope for something more dramatic. There is at least one more cohort to be reported on at the meeting, and maybe more (cf analyst reference to "a few dozen patients"). Recall that Dr Paul speaks of '360 as a favorite child, and several analysts give it more emphasis than it seems, to an outsider, to deserve.
If you listen to it, you can get a lot of color bearing on the response to the ASCO abstracts. The essential theme is that things will take longer than bulls might hope for.
Suppose, for instance, that the magic subgroup had turned out to be defined, in part, by an index of wasting--say weight loss or arm circumference loss. That wouldn't interact with any controversial hypotheses about disease mechanisms; it would come down to answering "Can the result be replicated?" and BANG! success or failure. But the subgroup is defined by an fairly crude indicator of general inflammation, in particular, a test that's interesting for its prognostic value but that doesn't directly show disease impact on the patient. The justification for pulling out the subgroup is a speculative connection between generaliazed inflammation and local events involved in tumor growth. The payoff may be MUCH larger, but it will require a lot more study to define.
The IDO situation is more fluid. In the cohorts discussed so far, a low dose produced a "half miracle" (there's no such thing as half a miracle) while an overdose produced just a hint of something worth fishing for. A middle-dose cohort has probably been studied, but we won't get results until the meeting. But the research needed to establish IDO inhibition as a general part of immunostimulatory cancer therapy, and the way to get a drug with little value as a single agent but great value as part of combinations onto the market will take a while.
And of course, the business problem of selling Jakafi for PV still hasn't been solved. There's a hint, but only a hint, that the results presented at ASCO will help define a strategy (some patients, perhaps, benefiting disproportionately from JAK inhibition).
But the abstracts just don't promise increased sales right away, and taking the conference broadcast as a context for them, the time frame may be closer to 18 months than to 6.
It seems my reply got truncated. The magic subset turns out not to be defined strikingly enough to attract immediate off-label use of Ruxo. Some, probably, but we'll have to wait for further results to see a big sales move. The cautious design of the p3 makes more sense with this information in hand.
I've swiped a definition of the modified Glasgow Prognostic Score: " The mGPS (0=C-reactive protein (CRP)less than or equal to10 mg l−1, 1=CRP 10 mg l−1 and 2=CRP 10 mg l−1 and albumin
I saw a comment that defining the magic subset by CRP level (which is how it turned out) is too easy and non-specific. If it works, bite me.
Seriously, CRP is a pretty general marker of inflammation, and it's too likely to be confounded in specific cases to justify an empirical move to putting all high-CRP cancer patients on Ruxo. The explosion in off-label use will be a little late this year. On the other hand, the trials to test whether the signal is real are already in late planning, if not enrolling, and more reliable information isn't unreasonably far in the future.
With a little time to reflect, this seems like "the new normal." The hot concept in cancer fighting these days is "checkpoint inhibition," which has the great virtue of lacking a definition, but means something like having a moderately effective tumor destroying agent (activated immune cells are especially popular) and giving other drugs along with the "warhead" one to knock out specific resistance mechanisms. There will need to be a lot of cross-company collaborations to flesh out this concept. It's good to see Incyte participating, but until some winners are identified we may need to learn to keep a relaxed attitude. There WILL be a next hot concept, and I'm happy to see that so far Incyte hasn't overcommitted to the present one.
And FWIW, the present enthusiasm isn't new nor is it fundamentally limited to anti-cancer drugs (the largest number of treatments annually with a main drug/drug enhancer combination is probably trimethoprim/sulfamethoxazole, an antibiotic).
Are you trying to get me to bore everyone? Nothing really new to say. If you expect a market disaster, it's probably better to avoid it than to try to hedge the risk. If you just expect a period when Mr Market yawns at good news, simple option strategies can do some good while you're waiting around. I DO like both INCY and ITMN; I think INCY has the better long-term prospects, but the US approval expected for ITMN's key drug in cal Q1 is the best short-term catalyst. Consider also MYGN, where the bull case is nice steady growth for years and the bear case is imminent total collapse--you don't get many differences of opinion THAT stark.
For some value of 'almost.' Not, I should say, one that I'd use.
IBB does have options, though, and strategies might be constructed that hedged your expectation for Incyte against risks to the entire sector.
I'm more interested in American Thoracic Society at the moment, where my co-favorite Intermune is going to be making presentations on efficacy, safety and tolerability of their Europe-marketed drug that is soon to be reconsidered for US approval. ITMN is much better known for being a much-manipulated stock than for its actual business, which may result in a favorable surprise.
I haven't been following them, and a lot of my usefulness with INCY and ITMN comes from having followed both companies for a long time.
That said, I'm concerned about how far you can push a drug for HoFH, an illness with a US prevalence in the low hundreds. Trying to expand such a franchise to more common indications is likely to run into severe practical obstacles
I like huge pipelines, but it's tricky to attach appropriate value to them. Remember that a new drug introduction uses a large share of a small company's resources, so doing say 5 in 2 years is not likely to be a wonderful prospect.
I highly recommend the afterword to "The Intelligent Investor:" you survive by your disciplined approach, but to make serious money you need to have convictions and follow them (and of course to be right occasionally).
When people flatter me I tend to bloviate, and this has been plenty of that.
A good Warren Buffett quote: "You want to learn from experience, but you want to learn from other people's experience when you can." Like the guys who write books, and guys like me with 40+ years of options experience..
I'll give you a freebie: when you have a conviction about how a stock ought to act, and you want to hedge yourself against market insanity (I'm still thinking about those short-duration puts), options on index funds may be more efficient than options on the stock at issue (spreads tend to be tighter, there are often more strikes to choose from and you may need fewer units in the hedge). I learned that after 2002; if I'd known it before, I'd have a lot more money today.
We appear to have had a paradox. At the same time MYGN is one of the most-shorted issues around, there were whisper (and not-so-whisper--see BoA/ML) numbers predicting a much better Q than reported. Upshot is that we may need to actually see how MyRisk does in the marketplace before a firm direction is established.
For the bulls: notice that Myriad is trying to establish BRACAnalysis as a companion diagnostic as a distinct entity, not the same as regular BRACAnalysis. Not certain to succeed, but lucrative if it does.
I don't know why I bother. Probably because so many people think all option users are as careless as you.
That isn't an argument. Retail buying of short-dated puts is suicidal (I guess it worked out for TWTR, but hey, you win Russian roulette 5 times out of 6). On the suicidal theme, you don't evaluate an option transaction until it closes--if you jump off a 50 story building it doesn't matter that you're fine passing the 30th story.
Selling calls with a January expiration is fine for established companies. For companies likely to experience a positive January effect, it has to be viewed as a multiple-leg strategy (you may well have to roll the calls to achieve maximum profit). Rollingcalls that have gone into-the-money is a delicate exercise (time premium decreases sharply in the last few days as risk of assignment increases sharply--guess wrong and you're on-the-hook for at least a stock trade commission, two if you want to rebuild the position)
If you're referring to the '110 vs psoriasis presentation, the specifics are news, but the trial's existence isn't. Psoriasis tends to need high drug doses, so the safety information is interesting.