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Biotech / Medical : Ligand (LGND) Breakout!

LGND 206.36

+1.4%

Nov 26 3:59 PM EST

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To: Cheryl Galt who wrote (29589)	12/13/1999 7:29:00 PM
From: Gregory Rasp	Read Replies (3) of 32384

<Plenty of sugar!> I absolutely agree! This is as good as it gets folks. CTCL is incurable. ALL patients that get the disease develop advanced disease eventually. It is debilitating in the late phases but easily treatable in the early stages. In my opinion, there was not a 'snowball's chance' of approval for recommending the drug for early disease. (I know that is easy to say now but I guess I did not realize they were even suggesting it). You see early disease does not require a drug with an unproven safety profile. You are not as a doctor going to subject someone who may live 10-15 years to a treatment that you know is not curative unless you are quite confident in the safety and efficacy of the product. It is entirely different to rationalize giving unproven therapy to an imminently terminal patient or one in which conventional therapy has failed (ie. the Advanced Stage patient). Just as a little background. CTCL often is diagnosed after a patient has had plaques on the skin for years. These have usually been misdiagnosed as psoriasis. The usual treatment course would start with mechlorethamine paste. This is a foul mixture the patient applies to the skin. Compliance is not great. After failure of this a dermatologist will often give PUVA therapy which is an ultraviolet activated treatment. A disadvantage is that the UV light penetrates only a short distance into the skin. Some of the plaques can become quite thick (eventually becoming tumors) at which point PUVA is usually abandoned. Next comes radiation (my field). Radiation treatments can either be given locally to a plaque or over the entire skin surface. The latter is more toxic but can often put a patient into complete remission for a few years. As the disease recurs it is common to 'spot weld' individual tumors or plaques over the ensuing years. I have seen this occur in up to 53 courses of radiation (though this is quite unusual). The important point is: Radiation is often the third line of defense and it has an extremely high response rate (90%+) and has the ability to control disease for many years. There is nothing in the Targretin data to support using it in lieu of Mechlorethamine, PUVA or Radiation. BUT as a salvage when these therapies fail, it will be invaluable. Possible as an adjunct during radiation as well! So Great News! Good job Ligand!! GR

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