Patient advocacy is something I care about and spend time actively supporting two worthwhile causes, including the lovely folks at Fight Colorectal Cancer, headed by the indefatigueable Carlea Bauman and Nancy Roach. As someone who has lost several family members to colon or rectal cancer, this is something dear to my heart. I got involved largely through being inspired by the incredible Kate Murphy, who sadly passed away last summer.
The recent approval of Sanofi/Regeneron’s VEGF targeted monoclonal antibody, ziv-aflibercept (Zaltrap) in combination with FOLFIRI, for the treatment colorectal cancer (CRC) after failure of prior therapy with the FOLFOX regimen has proven to generate quite a controversy.
The efficacy benefit, although modest at 1.4 months extra survival, is similar to that seen with bevacizumab (Avastin) in the same setting. The pricing, however, was clearly set at a premium at approximately $11,000 a month compared to less than half that for bevacizumab. I never thought I would be blogging about the price of Avastin actually looking very reasonable!
There’s been quite a flurry of commercial news on the Pharma front this morning, with Amgen buying Micromet (whose leading product is blinatumumab in ALL) and Celgene announcing their acquisition of Avila Therapeutics who have a Bruton Kinase Inhibitor (BTK) AVL-292 in phase IB development for lymphomas, which was all the rage at the recent American Society of Hematology (ASH) meeting last month.
The big news for me today, though, wasn’t the commercial acquisitions but a gem of a paper relating to science and its significance for future cancer treatment.
This week’s New England Journal of Medicine (NEJM) contained a fascinating article on how a specific gene mutation known as Transcription factor AP-2 epsilon, TFAP2E–DKK4, appears to be responsible for inducing at least some of the resistance to chemotherapy that occurs during treatment of colon cancer.
At first sight, I wasn’t sure from the abstract if they were referring to either adaptive resistance to therapy or whether genetic changes already present limited the effectivenes of the treatment.
Further reading of the full article more specifically pointed to the latter:
A couple of interesting developments have emerged over the last week with AKT and MEK inhibitors, specifically Merck’s MK-2206 and AstraZeneca/Array’s AZD6244, that are well worth discussing.
- At the ECCO/EMCC meeting in Stockholm last Tuesday, Johann De Bono discussed the combination data for MK-2206 and AZD6244 in KRAS driven colorectal cancer.
- Later the same week, Array Biopharma announced the initial results from a randomized phase II placebo-controlled study that compared the efficacy of selumetinib (AZD6244/ARRY-886) in combination with docetaxel compared to docetaxel alone in the second-line treatment of patients (n=87) with KRAS-mutant, locally advanced or metastatic non-small cell lung cancer (NSCLC).
I’m a subscriber to Science Translational Medicine and one of the things I really like about it is finding little gems like this – shared by Science Magazine on Twitter:
Breast cancer drug lapatinib boosts effects of apoptosis-inducing drugs in colorectal cancer
On clicking the link, I was delighted to see it was from Dr Wafik El Deiry’s group at Penn State, Hersey – you can find him as @weldeiry on Twitter – he tweets interesting snippets from various cancer conferences that he attends, including ones in GI cancers.
Here’s the essence of the paper that caught my eye:
The Holy Grail of colorectal cancer prevention – a reliable screening test that users don’t dread and avoid – appears to be getting close.
A novel test that detects telltale DNA markers in stool samples correctly identified 85 percent of colon cancers, 64 percent of significant precancerous polyps, and 90 percent of healthy samples, researchers announced Thursday in Philadelphia at a conference held by the American Association for Cancer Research.
“There is no other noninvasive screening test for colon cancer that comes close” to that accuracy rate, said David Ahlquist, a Mayo Clinic researcher who invented part of the technology and who is working with the commercial developer, Exact Sciences of Madison, Wis.
Later today I’m heading off to Philadelphia to attend a special conference at the American Society of Cancer Research (AACR) meeting on colorectal cancer entitled Biology to Therapy. There’s still time to pack a back and head on down as the main meeting doesn’t start until tomorrow.
Tonight, I’m very much looking forward to the Keynote from Prof Bert Vogelstein (Johns Hopkins) who is doing a talk entitled:
“Colorectal cancer genomes and their implications for basic and applied research.”
You can check out the full program here.
"Merck KGaA is reviewing heart risks of its tumor-fighting Erbitux drug in several types of cancer after European regulators asked for more information on the treatment’s safety.
The European Medicines Agency requested the review after rejecting Erbitux for use in lung cancer patients, according to a report published online on March 12. The drug regulator identified an “increased incidence of cardiac events” in lung cancer patients age 65 years or more, in particular high-risk patients with a history of heart problems."