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Cancer Vaccines Continue To Show Promise
I have to applaud the patience and diligence of the folks running Dendreon (Nasdaq:DNDN). After years of setbacks and complications (including three Phase 3 studies), the company and its investors finally saw the big payoff as the FDA approved the first-ever cancer vaccine - Provenge.
With Provenge now on the market, and the squabbling and speculating about reimbursement fully underway, the question moves to who might be next to advance a cancer vaccine to the market. Is this really a major new avenue of oncology, or is it a small access road along the bigger highway of traditional drugs?
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It Is a Vaccine ... Sort Of
What is a cancer vaccine? It actually isn't exactly what comes to mind for most people when they hear the term "vaccine". Instead of using a dead or severely weakened bit of a nasty disease (like polio or tetanus) and introducing that into the body to prime the immune system to fight it if and when it encounters the "real" disease, cancer vaccines basically train the body's immune system to recognize and attack cancer cells without harming the body.
There is a wide variety of vaccines under development, using a range of components like whole proteins, tumor antigens, dendritic cells, and so on. Additionally, each vaccine is custom-tailored to each patient, so you will not see the large-scale production facilities like you would for a flu shot. Given these idiosyncrasies, more and more sources refer to cancer vaccines as cancer immunotherapeutics. (For more, see Stocks On Drugs: What It Takes To Get High.)
Dendreon's First
As mentioned, Dendreon has the honor of being first in the market, and the FDA approved Provenge for use in patients with advanced prostate cancer. For all of the excitement, though, it is not anything like a cure. Provenge has been shown to increase median survival time by about four months, but it costs over $90,000 to administer. This cost-benefit ratio is leading to some questions about whether the vaccine is worth reimbursement; particularly since Sanofi-Aventis' (NYSE:SNY) Taxotere gives a similar benefit for less money. Here, though, "similar" is subjective - Taxotere extends survival by about 2.5 months, and there is a lot of public pressure to pay for even modest increases in survival
Who's Next?
Looking around the biopharma world, there are a few more cancer immunotherapeutics in late stage development. GlaxoSmithKline (NYSE:GSK) has its MAGE-A3 ASCI in Phase 3 studies for melanoma and non-small-cell lung cancer, as well as other compounds in earlier testing. Vical (Nasdaq:VICL) has its Allovectin-7 melanoma cancer vaccine in Phase 3 and is targeting six months or better in progression-free survival. Also in Phase 3 is Biovest International's BioVaxID for non-Hodgkin's lymphoma.
Still More on the Way
In principle, those aforementioned Phase 3 candidates should be in sight of the finish line if the Phase 3 is positive. And behind those are other compounds in early stages of development.
Outside of Dendreon possibly building upon Provenge, Celldex (Nasdaq:CLDX) may be the biotech most focused on cancer immunotherapeutics. The company's CDX-110 compound is in Phase 2 studies in glioblastoma, partnered with Pfizer (NYSE:PFE), and has shown to add eight months to survival - the best result I am aware of among cancer vaccines. Celldex also has monoclonal antibody-based cancer vaccines in development for a host of cancers including bladder, breast, pancreatic and ovarian cancers. (For more, see Measuring The Medicine Makers.)
Last and not least, Geron (Nasdaq:GERN) has its GRNVAC 1 and 2 in development, with a Phase 2 study in leukemia currently underway.
The Bottom Line
As you can see from the above discussion, relatively few public companies have bet their franchises on the concept of cancer vaccines. Moreover, I do believe the exceptional cost of these therapeutics could be a real limitation to their adoption; at a minimum I expect them to energize the debate on where to draw the line in cost-benefit tradeoffs for reimbursement. Consequently, investors should approach the concept with caution, but as Dendreon's stock has shown, the rewards can be significant. (For more, see The Ups And Downs Of Biotechnology.)
Use the Investopedia Stock Simulator to trade the stocks mentioned in this stock analysis, risk free!
With Provenge now on the market, and the squabbling and speculating about reimbursement fully underway, the question moves to who might be next to advance a cancer vaccine to the market. Is this really a major new avenue of oncology, or is it a small access road along the bigger highway of traditional drugs?
IN PICTURES: 20 Tools For Building Up Your Portfolio
It Is a Vaccine ... Sort Of
What is a cancer vaccine? It actually isn't exactly what comes to mind for most people when they hear the term "vaccine". Instead of using a dead or severely weakened bit of a nasty disease (like polio or tetanus) and introducing that into the body to prime the immune system to fight it if and when it encounters the "real" disease, cancer vaccines basically train the body's immune system to recognize and attack cancer cells without harming the body.
There is a wide variety of vaccines under development, using a range of components like whole proteins, tumor antigens, dendritic cells, and so on. Additionally, each vaccine is custom-tailored to each patient, so you will not see the large-scale production facilities like you would for a flu shot. Given these idiosyncrasies, more and more sources refer to cancer vaccines as cancer immunotherapeutics. (For more, see Stocks On Drugs: What It Takes To Get High.)
Dendreon's First
As mentioned, Dendreon has the honor of being first in the market, and the FDA approved Provenge for use in patients with advanced prostate cancer. For all of the excitement, though, it is not anything like a cure. Provenge has been shown to increase median survival time by about four months, but it costs over $90,000 to administer. This cost-benefit ratio is leading to some questions about whether the vaccine is worth reimbursement; particularly since Sanofi-Aventis' (NYSE:SNY) Taxotere gives a similar benefit for less money. Here, though, "similar" is subjective - Taxotere extends survival by about 2.5 months, and there is a lot of public pressure to pay for even modest increases in survival
Looking around the biopharma world, there are a few more cancer immunotherapeutics in late stage development. GlaxoSmithKline (NYSE:GSK) has its MAGE-A3 ASCI in Phase 3 studies for melanoma and non-small-cell lung cancer, as well as other compounds in earlier testing. Vical (Nasdaq:VICL) has its Allovectin-7 melanoma cancer vaccine in Phase 3 and is targeting six months or better in progression-free survival. Also in Phase 3 is Biovest International's BioVaxID for non-Hodgkin's lymphoma.
Still More on the Way
In principle, those aforementioned Phase 3 candidates should be in sight of the finish line if the Phase 3 is positive. And behind those are other compounds in early stages of development.
Outside of Dendreon possibly building upon Provenge, Celldex (Nasdaq:CLDX) may be the biotech most focused on cancer immunotherapeutics. The company's CDX-110 compound is in Phase 2 studies in glioblastoma, partnered with Pfizer (NYSE:PFE), and has shown to add eight months to survival - the best result I am aware of among cancer vaccines. Celldex also has monoclonal antibody-based cancer vaccines in development for a host of cancers including bladder, breast, pancreatic and ovarian cancers. (For more, see Measuring The Medicine Makers.)
Last and not least, Geron (Nasdaq:GERN) has its GRNVAC 1 and 2 in development, with a Phase 2 study in leukemia currently underway.
The Bottom Line
As you can see from the above discussion, relatively few public companies have bet their franchises on the concept of cancer vaccines. Moreover, I do believe the exceptional cost of these therapeutics could be a real limitation to their adoption; at a minimum I expect them to energize the debate on where to draw the line in cost-benefit tradeoffs for reimbursement. Consequently, investors should approach the concept with caution, but as Dendreon's stock has shown, the rewards can be significant. (For more, see The Ups And Downs Of Biotechnology.)
Use the Investopedia Stock Simulator to trade the stocks mentioned in this stock analysis, risk free!
by
Stephen D. Simpson, CFA
Stephen D. Simpson, CFA, is a freelance financial writer, investor, and consultant. He has worked as an equity analyst for both sell-side and buy-side investment companies in both equities and fixed income. Stephen's consulting work has focused primarily upon the healthcare sector, while he has also written extensively for publication on topics pertaining to investments, security analysis, and healthcare. Simpson operates the Kratisto Investing blog, and can be reached there.
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