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Small molecules are an increasingly viable option for cancer therapeutics
Pharmaceutical companies might have used this year's meeting of the American Society of Clinical Oncology to show they can perform on a stage that had been traditionally dominated by biotechnology firms.
But some of the biggest biotech companies say it's too early to say whether the stakes are complementary or in competition.
Not only have pharmaceutical companies taken a greater interest in biologics, but they are also discovering that small molecules can compete with monoclonal antibodies and other targeted therapies that are currently delivered through an infusion.
"Big Pharma has been making in-roads in their traditional [market] of small molecules," said Fred Cohen, MD, president of consulting firm Pharma Growth Strategies. "They're capitalizing on their strengths."
GlaxoSmithKline, for instance, received significant attention for Phase III data on small molecule Tykerb (lapatinib), which nearly doubled the time to progression of HER2 positive breast cancer compared with chemotherapy alone. The company also noted that Tykerb appears to reduce the risk of brain metastases that are associated with this type of cancer.
Amgen meanwhile presented data on an oral antiangiogenesis and anti-tumor drug, AMG 706, which is currently in Phase II.
"There's more competition than ever before," said Jim Daly, senior vice president of North America commercial operations at Amgen. "What we're seeing here is that Big Pharma is doing biotech work, and you're seeing biotech doing Big Pharma work. More and more, companies are trying to become modality independent."
Drugs that can be taken orally have the advantage of being more cheaply produced and possibly better tolerated because there have fewer immunologic concerns, Cohen said.
But, he added, "The overall cancer market is growing. There's room for everyone."
Genentech, for its part, has been hoping to expand the indications for which its products are approved. It presented more than 200 abstracts for 20 types of cancer, many of which target tumors that are harder to treat, like brain, kidney, and pancreatic cancers.
It is also hoping FDA will approve Herceptin (trastuzumab) to treat early-stage breast cancer, which could give it a leg up on Tykerb, a drug still being studied for more advanced stages of the disease.
"Last year we obviously had a lot of data for a single meeting," said John Orwin, vice president of Genentech's BioOncology unit, who added that the company has spent the last year trying to bring those products to market.
He called the increased interest in targeted therapies "a validation of the approach that Genentech has taken for a long time."
The company also presented early data on using targeted therapies in combination, as well as on a new compound that induces cell death, or apoptosis. The compound, dubbed Apo2L and developed in partnership with Amgen, is being tested for its ability to induce apoptosis in cancer cells while sparing normal ones.
Cohen noted that the largest chunk of the cancer market continues to be supportive care, an area dominated by Amgen.
But Daly said Amgen is also going head to head with companies that are developing cancer treatments, as well as building its supportive care portfolio. He referred to this year's meeting as a "coming out party" for denosumab, which is being tested for osteoporosis, treatment-induced bone loss, and bone metastases all at once.