New Cancer Treatments Represent Major Breakthroughs — But Who Is Going To

In In The News by Barbara Jacoby

By: John LaMattina


Corey Wood was a week away from her graduation from the University of California at Berkeley when she started getting flashes in one of her eyes. Her doctor was concerned and had an inkling that something serious was going on, so he took the unusual step of ordering a body scan. Corey was a healthy 22 year old who was tremendously fit and who had already completed eight marathons. Yet, stunningly, her tests revealed that she had stage IV lung cancer. The flashing of light she was experiencing was caused by a tumor behind her eye. But the disease was also in her lungs where there were multiple tumors and the disease had rapidly metastasized to her bones. Her prognosis wasn’t very good.

However, a sample of her tumor was sent to Foundation Medicine for genomic analysis and it was found that her cancer was being driven by an ROS-1 genetic alteration. Fortunately, a drug had been recently approved to treat this very type of cancer – Pfizer’s Xalkori (crizotinib). Xalkori is one of the new generation of drugs called targeted therapies, drugs specifically designed to treat Corey’s ROS-1 driven cancer in a way that does not cause the concomitant horrific side effects associated with traditional chemotherapy. After taking two Xalkori pills a day for three months, all the while going about her normal activities, Corey was cancer free.

Corey shared her inspirational story yesterday at the Forbes Healthcare Summit held in New York City. The eradication of her disease shows the power of the tools available to treat cancer that were thought of as science fiction just a decade ago, such as whole body scanning, genomic analysis of her tumor, and having a targeted drug available in the pharmacy to eradicate her disease. This approach to treating cancer is only going to get better. There are hundreds of targeted therapies in development in the pipelines of dozens of biopharmaceutical companies. There are other breakthroughs being made as well, particularly in the exploding field of immuno-oncology where drugs such as Yervoy (Bristol-Myers Squibb) and Keytruda (Merck) are helping to stimulate a cancer patient’s immune system to fight the cancer. These are incredibly exciting times.

After Corey’s talk, Forbes’ Matt Herper led a panel discussion with Peter Bach (Memorial Sloan Kettering Cancer Center), Bob Hugin (CEO, Celgene CELG -2.5%), Richard Klausner (CMO, Illumina ILMN -1.91%), and Sandra Swain (Medical Director, Washington Cancer Institute). The session tried to answer the question “Are we at a tipping point for cancer and are we on the doorstep of vanquishing this disease?” This was a great discussion about changing treatment paradigms, access to healthcare, and emerging science. But Bach brought the group to the key issue facing oncology – the costs of treatment. Yervoy and Keytruda are great drugs, but they cost $120,000 and $150,000 per year, respectively. Furthermore, these drugs are not going to be used as stand-alone agents. Rather they will be used in combination with other drugs such as targeted therapies.

The good news is in the not too distant future, a cancer diagnosis will not be a death sentence. Rather, this will be a treatable condition controlled by taking a combination of these breakthrough therapies. However, people may require a combination of these therapies for the rest of their lives. Imagine millions of people needing a cocktail of three drugs, each of which costs $100,000/year/patient. It doesn’t take major economic analyses to realize that the costs inflicted on the healthcare system will not be sustainable in such a scenario. One possibility is that companies could form alliances to sell optimal combinations of their drugs at a cost commensurate with the value it brings to patients.  While they would have to split the profits, favorable pricing could be garnered with far less than a $300,000 price tag.

Unfortunately, the group didn’t have a solution. The panel discussion ended with Celgene’s Bob Hugin saying that innovative solutions are needed for developing a system that rewards scientific breakthroughs without crushing healthcare budgets. Of course, he’s right. However, I didn’t get the sense that people were going off to address this problem. Yet, this needs to be solved and quickly. A number of new cancer fighting drugs are being approved annually, and wonderful stories like Corey’s will become more and more common. But if the biopharmaceutical industry doesn’t find a solution, I fear that one will be imposed on them and that won’t be good for anyone.