Not sure, but bone is in a constant state of remodelling in maintaining serum calcium. Osteoblasts and osteoclasts are continuously at work forming and consuming bone. I suspect when a cancer regressess in that microenvironment the normal yin/yang of homeostatic mechanisms return the bone to a more normal structure, albeit with some sclerosis remaining.
Speaking as a busy practicing medical oncologist here...
RA223 requires "hoops" to jump through, setting up referral, montioring blood counts closely, etc. This generally means referring your patient out to a different subspecialty (radiation oncology most likely).
There are concerns about "radiation" to patients and family. Have to use different toilet, etc. Being "radioactive" is scary to people, very scary.
If Cabo shows similar data for efficacy and pain improvement, and has demonstarated activity in soft-tissue disease it will be the clear winner. Urologists likely will prescribe Cabo as well, and thus hold onto patients longer in their practices. The one caveat being 21st Centuary Oncology (huge radiation group) that is buying urology practices all over the country...for obvious reasons.
It is a much easier discussion to tell a patient, "I am going to start a pill daily and monitor labs monthly (and EKG), and we can titrate the dose based upon side effects. Oh, there is also data that this should significantly reduce your pain, and treat cancer cells everywhere in your body not just your bone."
Much easier "sell."
Furthermore, if data starts to emerge with tolerability and activity with Zytiga in earlier stages it will become a very well understood medicine that will be a "go to" drug. Once Docs get used to a medicine's dosing and side effects they develop a comfort level and will keep trying to use it whenever it has a potential use. Just look at "popular" antibiotic choices like Levaquin daily, and Z-Pac...their use far exceeds the data supporting their indication in my opinion.
This can be a dangerous thing, and if Oncology isn't already expensive enough.....
The mutation may be a "driver-mutation" in one cancer, but not in another...I still think we should be guided by well-designed clinical trials that assess efficacy and tolerability and not get wrapped up in a mutation game.
Old news...but it does make one hopeful that Comet 1 will indeed be a positive study given its comparison to prednisone...which is essentially placebo in my mind.
I am long.
2014/2015 will be important...
This is a small company with a future dependent upon yet to be realised data.
Everything else is noise in my opinion.
In my opinion I think they are firing on all cylinders at this point.
I too am getting the feeling that "something is going on." Anyone who has an understanding of the world of oncology was not too surprised by the 901 result. They continue to extend licenses to multiple Partners (who clearly are savvy Pharma execs still with faith in the technology). They also have an active research program with very interesting compounds in much more assailable disease states; moreover, T-DM1 will only increase is sales over the next 2-3 years. No question there.
The drop in price seems underserving to me.
Agree...I never had any expectations for 901. That is what irritates me about this mess; and why I called IR yesterday for the first time ever. I explained that while I am no Biotech CEO I could have anticipated the backlash from this news release and prepared a simultaneous positive news release about the vitality of the Company and the technology platform. Instead, with silence, they have watched the stock drop hugely. I can only assume that someone wants that to happen to have a window of opportunity to accumulate more....but perhaps I am being too cynical.
I pointed out all the positives and misinformation about this to the IR person, and she said, "You took the words right out of my mouth." To which I replied, "Then why don't you guys actually SAY those words?!"
If Comet 1 is positve I can't imagine this stock being less than $25 (~$5B valuation). I also think HCC and Renal trials are interesting. If all three hit, or four if you include Comet2, I would think this stock would easily climb north of $50. MDVN hit $100 with just Xtandi and one indication, though they had fewer shares outstanding than EXEL.
I'm not sure why they would want to allow themselves to be bought out. Certainly after all this time and effort they are not planing on giving the company away at the very least.
I'm in this for the whole ride...hopefully by end of 2014 it will have crystallized, but possibly early 2015 may be necessary depending on enrollments for HCC and Renal. Later 2015 or 2016 for Zytiga/Coemtriq in PSA biochemical failure.