SI
SI
discoversearch

We've detected that you're using an ad content blocking browser plug-in or feature. Ads provide a critical source of revenue to the continued operation of Silicon Investor.  We ask that you disable ad blocking while on Silicon Investor in the best interests of our community.  If you are not using an ad blocker but are still receiving this message, make sure your browser's tracking protection is set to the 'standard' level.
Biotech / Medical : CLTR COULTER PHARMACEUTICAL -- Ignore unavailable to you. Want to Upgrade?


To: David Cathcart who wrote (299)9/2/1999 9:12:00 PM
From: Edscharp  Respond to of 666
 
ragingbull.com

Medical misconception
Biowatch 09/02/99 4:00 PM
By Emmanuel Tzavlakis

Occasionally, the biggest gains in biotech investing
are made when the market overreacts to what may
seem like unfavorable data, only to find out that they
misjudged a minor setback and the stock shoots
back up. This week's focus is on Coulter
Pharmaceuticals (CLTR), a San Francisco-based
biotech recently asked to provide the U.S. Food and
Drug Administration with additional analyses of
oncology compound Bexxar. Investors took this as a
bad sign and punished the stock on August 30,
driving it down to close at 23 1/2, a loss of 32% from
its previous day's close. Overreaction or future dog
stock? Let's check it out.

Bexxar

Bexxar, whose chemical name is iodine I 131
tositumomab (imagine saying that repeatedly in a
meeting), was developed to treat non-Hodgkin's
lymphoma (NHL) in patients who have not responded
to first-line treatments, or who have improved and
then relapsed. It was originally filed for FDA approval
in June of 1999, and was expected to be on the
market by the end of the year. The drug was
originally given "Priority Review" by the FDA, which
means that Bexxar was thought to address a
life-threatening disorder and target a disease where
there is no current therapy.

So why the heart-stopping drop on Monday? The
FDA is asking for reformatting of data and additional
analyses of existing data. This is a problem because
it starts the review process on the wrong foot and
delays approval, but can still be reconciled. More
importantly, no additional trials were requested, and
there were no issues with the primary efficacy data
or with the manufacturing process. Coulter expects
to provide these items within four to six weeks and
re-file the BLA (Biologic License Application) in
mid-October. This would allow for final approval and
launch around April, about four months behind
schedule, and would cut into year 2000 sales

But the clinical data on Bexxar is impressive, and
should help bolster sales into 2001 and beyond.
While IDEC Pharmaceutical's (IDPH) Rituxan is
approved for the treatment of refractory low-grade
(slow-growing) NHL patients, and has done
extremely well since its launch, Rituxan does not
currently treat transformed low-grade patients whose
cancer accelerates from slow-growing to aggressive.
In contrast, Bexxar has shown a response rate of
39% in these transformed low-grade patients,
amazing numbers since no other therapy has shown
efficacy in this group.

Sales projections

When it's discovered a patient has NHL, a doctor will
originally put the patient on Rituxan. If that fails,
that's where Bexxar steps in. Robert J. Toth, Jr., of
Vector Securities estimates that close to 35,000
NHL patients have now taken Rituxan, and with a
50% response rate, some 17,000 patients have
failed to respond to the therapy. This automatically
creates a 50% market opportunity for Bexxar in an
unfortunately expanding pool of NHL patients. Toth
sees 2000-2002 sales estimates of $85 million, $169
million, and $268 million respectively, which he will
probably revise downward after the recent FDA
developments.

SmithKline Beecham co-market

In 1998, Coulter inked a deal with SmithKline
Beecham (SBH) that gives SB the right to
co-promote Bexxar in the United States and full
marketing rights in Europe. This will allow Coulter to
reach all aspects of the clinical market rapidly,
including the hospital and physician office settings,
with SB contributing about 30 sales representatives
to the cause.

The terms of this deal, valued at $132 million, are
extremely positive for Coulter, providing it with a 50%
share of profits in the U.S. This is a great deal
considering many biotechs only get to keep royalties
of somewhere in the neighborhood of 10-25% of
profits.

Cash, pipeline and competition

With $132 million reaped from the SB deal, Coulter
doesn't have to worry about raising cash in the near
future. After Bexxar, the company is looking at a
program called TAP (Tumor-Activated Peptide),
which tests numerous cancer drugs over one
platform, and may potentially be more effective than
current cancer treatments. Unfortunately, the
company has not entered clinical trials as of yet,
pinning entire corporate hopes on Bexxar for at least
three to four years.

In addition to Rituxan, IDEC has another therapy in
Phase III trials named Zevalin, which unlike its sister
medication, treats transformed low-grade NHL,
making it a direct competitor to Bexxar. Zevalin is
projected to be on the market in 2001, which means
the one-year lead Bexxar was going to attain has
shrunk to about seven to nine months. However,
analysts who are dumping Coulter and buying IDEC
are forgetting that there is room for multiple players
in this market. The real issue is, can Coulter and SB
overcome this FDA hurdle and take Bexxar from a
clinical to a marketing success? Absolutely. I think
the analysts have overreacted on this one.

Nabi staph vaccine

Boca Raton, Florida-based Nabi (NABI) has
developed a vaccine designed to protect people from
staph infection, a serious complication for some
hospital patients. Nabi was looking to reduce the
number of infections by 60%, and it has seen
positive data towards achieving that goal.
Staphylococcus aureus accounts for about 15% of 2
million hospital-related infections recorded in the
United States each year. The vaccine, which is
currently in Phase III trials, would be a welcome
addition to the current stable of antibiotics. Is it
really that effective? We will know for sure in about a
year. If the data supports moving ahead, Nabi could
apply for approval as soon as the fourth quarter of
2000. And if the FDA places the review on fast track
because of the urgency of the need, a decision could
come within six months.

At the time of publication, Emmanuel Tzavlakis was
long shares of Nabi.



To: David Cathcart who wrote (299)9/3/1999 7:45:00 PM
From: Gordon James  Read Replies (2) | Respond to of 666
 
Another article slanted against CLTR.

Quite a broadside from IIO! Heavily influenced by the shorts as you mention, and sneeringly dismissive of the analysts who remain positive. As I suspected, one of the biggest issues going forward now will be management credibility, and the shorts should be expected to shower the writers they know with this argument. But IMO, the arguments here aren't entirely convincing, a little bizarre in one case, and the writer just seems to have let himself be a mouthpiece of the shorts, who haven't seen fit to confine themselves to quality arguments as yet (happy to beat CLTR with any and every stick they can find so far).

They've really latched onto the 45 vs. 60-day notification issue, and they've got an argument here worth some thought, although I don't think it's an open-and-shut case. How do we feel about management credibility now? First, from the IIO piece...

On June 30th, Bexxar was submitted for FDA marketing approval as a Biologics License Application (BLA). The FDA has 45 days from that point to accept, request additional information or reject the BLA, which in Coulter's case was granted 'priority review' status.

The company even noted this timeframe in a July 22 press release.


OK, lets see what was in the July 22 press release from the company:

The FDA is expected to determine acceptability of the license application within 45 days of the submission.

That's "determine acceptability", not "notify us" or "have completed all discussions with us about any potential problems" or "officially notify us with reasons for rejection". I'm OK so far.

I think the bigger question has to do with the contention by Coulter that they didn't know the filing was in trouble, and were blindsided by the rejection letter. How do we explain the following statement from the article?

A spokeswoman for the company called the letter 'unexpected' and said Coulter had not received any word from the FDA of the application's status prior to it.

Sounds fishy at the outset, we know that all kinds of discussions must have been going on between company representatives and the FDA. Ultimately not damning to me, however, because we don't know how the FDA issues were represented to Coulter as the process went along. Perhaps the issues were not presented up front as showstoppers which would necessitate re-filing the BLA and starting the six-month clock over - so it's possible Coulter was aware of the issues and had discussed them with the FDA, but ended up surprised that they turned out to be show-stoppers. If this wasn't the case, its still possible that it was a complete blindside from some overburdened FDA staffers who hate the 6-month priority review process, as has been suggested - if they really wanted more time, the best way to get it would be to throw out some previously unmentioned or little-mentioned issues at the last minute. Ultimately, only those closest to the action here know the real story, for investors perhaps it now depends on whether one is still willing to give management the benefit of the doubt on this.

As far as the timeliness of notification - we have been told that the official FDA notification was faxed to Coulter on day 60. Assuming this is true, what were the valid options for management notification of the public and shareholders? If we buy the argument of the shorts, Coulter should have issued a press release something like this on day 45:

Our application has been rejected.
We can't tell you much about why, we don't have the official letter from the FDA yet.
We're still discussing with the FDA exactly what these points are, but trust us, they look minor.


Imagine the shareholder panic we might have gotten. A nice rule-of-thumb about dealing with powerful bureaucracies - don't publicly misrepresent their communication to you, accidentally or otherwise. If you've been having some discussions, and they're going to send you an official letter about an issue, wait until you get it before issuing your press releases about what's going on. If I'm management, I want a signed FDA document in my hands before I make public statements about how they view my filing.

IMO, I'm quite satisfied with how management handled the notification. At the same time the news came out, management gave or had given to analysts detailed information about what the holdups were, based on the official FDA notification, and folks were able to make informed decisions about the severity of the delay. I, for one, was able to make much better decisions about what to do based on that information, than if I had gotten some panicky, vague, unofficial information about a rejection on day 45.

As for the somewhat bizarre part, I submit the following from the article:

He also has some issues with the technology itself. 'Even if this drug is approved, it's not going to be as significant a player as people think,' says Sadeghi. Bexxar uses a radioactive isotope that he notes will prevent the majority of oncologists (dealing with cancer) to administer it themselves, thus discouraging them from using it except as a last resort.

Huh? Right now, Bexxar looks to be the single most powerful agent we have against low-grade NHL, with a surprisingly moderate side-effects profile. So none of these characteristics will prove strong enough to gain more than a salvage role, especially versus toxic chemo regimens? Perhaps Mr. Sadeghi doesn't agree that Bexxar represents a significant treatment advance, but I think he's fighting an uphill battle against the trial data so far. If there's a clear treatment benefit shown for using Bexxar at any point in a patient's treatment versus the alternatives, oncologists will prescribe it at that point, regardless of where it will be administered. But if Mr. Sadeghi is willing to admit that there's some likely treatment benefits to using Bexxar (which seems implicit in his assumption we will be able to use it as a last resort treatment), then we'll have to conclude that Mr. Sadeghi must be unfamiliar with the cancer treatment modalities known as radiotherapy and surgery - commonly administered as first-line cancer treatments, but not ordinarily administered by the general oncologist in his office. By this sort of logic, we would have to conclude that all cancer patients generally receive drugs as their first line therapy because that's the easiest thing for their oncologists to do...

Finally, regarding the competitive situation with Zevalin. From the article:

Even assuming an eventual FDA approval, there are competing products coming to market. Sadeghi specifically refers to IDEC Pharmaceuticals' (NASDAQ:IDPH - news) opportunity to catch up with its Zevalin drug now in Phase 3 trials.

I'll be more excited about Zevalin when IDEC is able to show us results from a Zevalin trial that don't include over half of the patients experiencing severe or life-threatening (grade 3 or 4) myelosuppression, unlike the mostly moderate myelosuppression seen in Bexxar trials. Numerous other areas where Zevalin appears inferior, but I'll take improvement in this area for starters...

Gordon