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Dispatches from the War on Cancer

By Catherine Arnst One in three Americans can expect to die from cancer. The enormous efforts of medical researchers seeking to change that grim statistic will be showcased May 13-17 in Orlando at the world's largest cancer conference, the annual meeting of the American Society of Clinical Oncology.

This is the main forum for releasing data on clinical trials of the latest cancer drugs, particularly the new generation of targeted therapies that take aim at tumors without harming healthy tissue. Consequently, ASCO not only affects the care of patients but the fortunes of the companies reporting that data -- particularly biotech firms, the leaders in cancer research.

This year, however, the traditonal Big Pharma companies will try to regain a place at the table. Some of the most closely watched studies -- all embargoed until their release at the meeting -- will come from Pfizer (PFE), GlaxoSmithkline (GSK), Bristol-Myers Squibb (BMS), and Bayer (BAY).

NEW BEST-SELLER? Nevertheless, the real heavyweight at the meeting will be Genentech (DNA), which is having a very good year. Genentech has four of the most innovative cancer drugs on the market and will be represented by some 150 studies at ASCO, including 32 alone on Avastin, approved for colon cancer in February, 2004.

Avastin is the first of a promising class of drugs that block blood-vessel growth to cancer cells, and the first targeted therapy to extend the survival of late-stage colon cancer patients, one of the hardest groups to treat.

In April, Genentech announced that the drug also extended the lives of breast cancer patients, and details of that trial will be released at ASCO. Doctors and stock analysts alike will also be closely watching a study testing Avastin in combination with traditional chemotherapy for lung cancer. At this point, analysts expect Avastin to be the biggest-selling cancer drug ever if it keeps racking up successes against different types.

GENE PATROL. Genentech will also be releasing the results of studies involving its breast cancer drug Herceptin; Tarceva, which it jointly developed with OSI Pharmaceuticals (OSI); and Rituxan, co-owned with Biogen-Idec (BIIB).

Beyond the Genentech treatments, there's a lot of interest this year in an emerging class of drugs that inhibit several different genes involved in cancer growth and mutations. These multitargeted drugs are being tested in some of the hardest-to-treat cancers, among them kidney, stomach, and a rare form of leukemia.

The two leading compounds are Pfizer's Sutent and Bay-43-9006, jointly developed by Onyx Pharmaceuticals (ONXX) and Bayer. Earlier this year, Pfizer reported that Sutent, which the company acquired through its takeover of Pharmacia, is effective in certain types of stomach cancer for patients who have grown resistant to Gleevec, a breakthrough Novartis (NVS) drug. Oncologists were especially pleased with this result because it proves the principle that patients whose disease grows resistant to one targeted therapy can be switched to another.

WHO WILL PAY? Details of the Sutent stomach cancer trial will be presented at ASCO, as well as results from a test of the drug against kidney cancer. Attendees will be closely comparing the kidney results to those of a late-stage trial with the Onyx-Bayer drug. BristolMyers Squibb also has a drug in development in this category, BMS-354825.

GlaxoSmithKline has its own multitargeted drug, Lapatinib, that's getting a lot of buzz. This treatment is for breast cancer, and the company is expected to seek Food & Drug Administration approval for it by yearend. Lapatinib is aiming for many of the patients now treated with Genentech's Herceptin, which is most effective against the 25% to 30% of breast cancer tumors with the Her-2/neu genetic mutation. Herceptin, however, must be taken intravenously, while lapatinib is an oral drug, giving it an edge in ease of use.

Plenty of other innovative treatments will grab attention, including Telcyta from Telik (TELK), for lung cancer, and Novartis' PTK787 for colon cancer.

But perhaps one of the biggest general issues to be discussed at the meeting is how our the straining U.S. health-care system will pay for all these new cancer treatments, which tend to cost between $10,000 to $20,000 per course of treatment. The financial component is one area that is sorely lacking in research. Arnst is a senior writer for BusinessWeek

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