To: tuck who wrote (168 ) 8/27/2002 10:34:39 PM From: Miljenko Zuanic Read Replies (1) | Respond to of 447 V1, I see good chance that Iressa will have relative positive review by AC, however FDA will be concerned with off-label usage (combination with chemo and other cancer type) and it will take time for full approval. Zeneca need explanation why drug does not synergy with chemo, and work (IF at all) later when chemo fail. Similarly, Tarceva may have the same fait at FDA if chemo-combination results do not show at least small survival benefit. Tarceva (at 100 mg) in combination with Gemzar for pancreatic have small chance to be effective, imo. The problem with OSIP is not Tarceva. It is luck of the pipeline progress and near term too narrow focus on oncology. However, I had similar opinion on IDPH-DNA (1997/98) and Rituxan, and was wrong. DNA hope is Herceptin-Tarceva combination, imo. Tuck, CI-1033 is from WL. PFE didn't have its own oncology program (other than collaboration with OSIP). So, if antitrust dictate return of the Tarceva to ISIP because of the competitive reason why not complete oncology program (which PFE did cancel few months later, after VEGF failure)? The concerning is Zeneca (WAS and IS leader in TKIs and oncology) decision to discontinue Iressa with chemo combination (at least for front-line NSCC and platinum based therapy). Like PFE, Novartis, GSK,.. they have multiple receptors inhibitor and broad TKIs program. Point may be that competitive EGFr ATP inhibitor is not sufficient to compensate alternative paths in signaling. Antibody to EGFr compete with EGF/FGF (ligands for receptors) and receptors internalization without signal may disturb natural sells signaling and cause apoptosis, accelerated differentiation. Which cause tumor regression in xenografts model. Btw, recent Biocentury (thanks Rudy) have nice article on Iressa and other EGFr inhibitors in clinic. While I do not buy possibility of the Iressa protocol failure or chemo-induced faster Iressa clearance, I think that Zeneca broad point on EGFr-class inhibitor was related to small molecule selective and ATP competitive toward single EGFr. Miljenko