I have had 40 years experience at a tertiary teaching hospital. Early on I was long INCY. I am now short for the following reasons:
1. In my experience and that of my colleagues JAKAFI can be helpful in a selected subgroup of MF patients(including prolongation of survival), but for the bulk of MF patients it is no great shakes, particularly when taking the great expense of the medicine into account.
2. It is widely quoted that the polycythemia vera study is in patients who became "refractory" to the standard therapy for PV in patients over 60 which is hydroxyurea(HU). However, the information I find is that Jakafi is simply being compared to HU in patients who have not been recently treated with phlebotomy or HU. I agree that Jakafi will show reduction of nite sweats, itching, bone pain, etc vs HU in the relatively small group of PV patients who have significant symptoms, but very few hematologists will prescribe such an expensive drug except for the most extreme cases, particularly since there are inexpensive alternatives such as low dose steroid, ibuprofen, benadryl, etc.. Hence, I see the PV market as MUCH smaller then advertised.
3. Sanofi, Gilead and Geron have competing JAK-2 inhibiors in advanced development for MF; competition is not that far away. The Gilead drug in particular looks good with much less tendency to cause low platelets.
4.The recent 35% jump in stock price is totally out of proportion to the long term significance of a phase1 study involving a small number of patients. Bulls are acting like this is a slam dunk to help all solid cancers. The market cap is now up to 5.5 billion!
Happy to hear responses to my arguments.
Big study comparing old standard of chlorambucil to lenalidomide in CLL halted early because of increased deaths in lenalidomide arm. Lenalidomide unquestionably a maqjor drug in myeloma, but NOT in CLL. Bad news for CELG and good news for PCYC