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Biotech / Medical : Ligand (LGND) Breakout! -- Ignore unavailable to you. Want to Upgrade?


To: Russian Bear who wrote (14573)2/11/1998 6:43:00 AM
From: Henry Niman  Respond to of 32384
 
RB, LGND's press release is light on the "spontaneous" response rate which may be impacted by other drugs (I believe that these advanced patients were on at least one PI). However, both studies gave a similar response rate and the end point seemed to be fair rigorous (shrinking of tumor). I looked up the BMY press release on Taxol, and it was even vaguer than LGND's. They indicated that over 50% of the KS patients benefited, but it looks like one of the end points was pain relief and response rate was relatively short:

Oncology Drugs Advisory Committee Recommends TAXOL(R) for
Kaposi's Sarcoma

PRINCETON, N.J., June 23 /PRNewswire/ -- The Oncology Drugs Advisory
Committee (ODAC) today recommended that the U.S. Food and Drug Administration
approve TAXOL for the treatment of Kaposi's Sarcoma (KS).
"As a research-based company, and a leader in the fight against AIDS,
Bristol-Myers Squibb is extremely pleased by ODAC's recommendation that the
FDA approve TAXOL for the treatment of Kaposi's sarcoma," said Rick
Winningham, President, Bristol-Myers Squibb Oncology/ Immunology Division.
"With the Committee's favorable reception of the data, we hope for a rapid FDA
approval."
Kaposi's sarcoma is a rare form of cancer, but it is the most frequent
malignancy in HIV-infected individuals. Current estimates indicates that of
the 202,535 people living with AIDS through June 1996, about 20% (or 40,000
patients) are or will be affected by Kaposi's sarcoma, according to estimates
provided by the Centers for Disease Control and Prevention.
In clinical studies, a high proportion of patients treated with TAXOL
benefited from prolonged control of the disease. The median duration of
response was 8.2 months. For all patients, the median time to progression of
disease was 6.5 months. In addition, TAXOL therapy provided improved symptom
reduction, including reduced edema (fluid accumulation), healing of lesions on
feet, healing of facial lesions, reduction of pain, reduction of pulmonary
lesions and general improvement of the patient's performance status. The most
common side effects among patients in the studies was myelosuppression (a
reduction in bone marrow cells). Other side effects included alopecia,
arthralgia/myalgia and peripheral neuropathy.
"This is another major step for the company in its ongoing commitment to
explore new uses for TAXOL," said Mr. Winningham. "Further, we believe this
application demonstrates our commitment to fighting HIV/AIDS. Our immunology
portfolio currently includes Videx(R), ZERIT(R) and Megace(R) OS, and we are
optimistic about adding TAXOL to this distinguished line of medicines."
Bristol-Myers Squibb (NYSE: BMY) is a diversified worldwide health and
personal care company whose principal businesses are pharmaceuticals, consumer
products, nutritionals and medical devices. It is a leading maker of
innovative therapies for cardiovascular, metabolic and infectious diseases,
central nervous system and dermatological disorders, and cancer. The company
is a leader in consumer medicines, orthopaedic devices, ostomy care, wound
management, nutritional supplements, infant formulas, and hair and skin care
products. The company will invest about $1.5 billion in research and
development in 1997.

SOURCE Bristol-Myers Squibb Company


CONTACT: Jane A. Kramer, 609-252-5185, or pager, 800-475-8947, or
John Kouten, 609) 252-5456, or pager, 800-461-7518 /Bristol-Myers
Squibb press releases available through Company News On-Call by
fax, 800-758-5804, ext. BMYFAX (269329) or at
prnewswire.com



To: Russian Bear who wrote (14573)2/11/1998 6:49:00 AM
From: Henry Niman  Read Replies (1) | Respond to of 32384
 
RB, While looking for the BMY press release on the FDA rec, I ran across the press release on the FDA approval. Note that the rec was given on June 23 and the approval was Aug 5. The very short time between the rec and the vote to approve, indicates that the FDA still considers this a very serious condition and is not relying on other treatments (PIs). I think that LGND's results are very good news, which is why LGND is leaping over the Phase III APL trial and moving this indication into the forefront. Current treatments leave much to be desired, and popping one pill a day should grab market share big time:

FDA Clears TAXOL for AIDS-Related Kaposi's Sarcoma

PRINCETON, N.J., Aug. 5 /PRNewswire/ -- Bristol-Myers Squibb (NYSE: BMY)
today announced that the U.S. Food and Drug Administration has cleared
TAXOL(R) (paclitaxel) Injection for use in second-line treatment of AIDS-
related Kaposi's sarcoma (KS).
Bristol-Myers Squibb (BMS) pioneered the commercial development of TAXOL
beginning in 1991. Collaborative work with the National Cancer Institute
(NCI) in 1993 led to the discovery of TAXOL activity against KS.
Subsequently, Bristol-Myers Squibb sponsored a larger independent clinical
trial to confirm the initial NCI/BMS TAXOL Kaposi's sarcoma data. BMS
continues to fund studies of TAXOL in Kaposi's sarcoma patients while pursuing
ongoing research of TAXOL in many other tumor types.
"To ensure the widest availability and reimbursement of this treatment for
Kaposi's sarcoma, we invested in the necessary clinical development of TAXOL
for KS," said Renzo Canetta, M.D., vice president, Oncology Clinical Research,
Bristol-Myers Squibb. "We published significant data in the scientific
literature on TAXOL Kaposi's sarcoma findings."
In clinical studies, a majority of KS patients treated with TAXOL, all of
whom had failed prior therapy, benefited from treatment with TAXOL. TAXOL
therapy provided tumor shrinkage and symptom reduction including reduced edema
(fluid accumulation), reduction of pain, and general improvement of the
patient's performance status. The most common side effect among patients in
the studies was myleosuppression (a reduction in bone marrow cells). Other
side effects included hair loss and muscle soreness.
Current estimates are that 202,000 people in the U.S. are living with
AIDS. About 20% or 40,000 of them will be affected by KS at some time during
their illness, according to the Centers for Disease Control and Prevention.
BMS applied for and the FDA granted orphan drug status for paclitaxel for this
indication.
"BMS is a world leader in the development of drugs for AIDS and cancer,"
said Rick Winningham, president, Bristol-Myers Squibb Oncology/Immunology
Division. "To date, BMS has sponsored more than 500 TAXOL clinical trials
involving 40,000 patients to explore new uses for the drug and thus, it
remains one of the most intensively researched anticancer drugs."
In addition to TAXOL, Bristol-Myers Squibb markets Zerit(R) (d4T,
stavudine), Videx(R) (ddI, didanosine), Megace(R) OS (megestrol acetate) and
Fungizone(R) OS (amphotericin B) for use in the treatment of HIV disease. BMS
is also currently developing two new protease inhibitors for the treatment of
HIV/AIDS.
Bristol-Myers Squibb is a diversified company whose main focus is
worldwide health and personal care. The principal businesses are
pharmaceuticals, consumer products, nutritionals, and medical devices. It is
a leading maker of innovative therapies for cardiovascular, metabolic and
infectious diseases, central nervous system and dermatological disorders, and
cancer. The company will invest about $1.5 billion in research and
development in 1997.
Visit Bristol-Myers Squibb on the World Wide Web at: bms.com

SOURCE Bristol-Myers Squibb Company


CONTACT: John Kouten of Bristol-Myers Squibb, 609-252-5456, or
pager, 888-985-7407



To: Russian Bear who wrote (14573)2/11/1998 8:28:00 AM
From: Henry Niman  Respond to of 32384
 
Here's the protocol that LGND was using for their trial (I'm still looking for the AIDS Consortium protocol which came down when they completed the Phase II trial):

KS Treatment: ALRT1057 Oral
Capsules

Last updated:08/29/1996

Title:

L1057-28: A Phase II Evaluation of Oral ALRT1057 in Patients with AIDS-Related Kaposi's
Sarcoma

Purpose:

To see if oral ALRT1057 (also called PANRETIN or 9-cis retinoic acid) is safe and well tolerated
and to see if it is effective in treating KS lesions in AIDS patients.

About the study:

This is a dose-escalation or dose-ranging study. This means that patients will enter the study taking
the lowest dose of oral ALRT1057. The dose will gradually be increased over time until the
maximum dose that researchers plan to study has been given. All patients will receive oral
ALRT1057. There are no placebos in this study. Oral ALRT1057 is a capsule and taken once a
day. Study visits are every two weeks and the study lasts 16 weeks. If the study remains open and
active, patients may continue treatment for as long as the treatment is considered to be of clinical
benefit and has not shown severe side effects.

Required:

CD4 cell (T-cell) range: not specified
Viral load range: not specified
HIV positive
At least 18 years old
Diagnosis of KS proven by biopsy. Patients must have a minimum of six skin lesions, three of
which are raised, and have been present for at least 30 days or measure at least 1.0 cm
Must have been on approved antiretroviral therapy for at least 6 weeks prior, during, and at
least one month after drug discontinuation

Not Allowed:

Women who are pregnant or breastfeeding
Systemic treatment for KS within 30 days of study entry
Systemic treatment with Vitamin A (more than 15,000 IU per day) or other retinoid class
drugs within 30 days of study entry
Previous treatment of indicator lesions with any local or topical therapy within 60 days of
study entry
Current serious illness or infection which would interfere with the ability of the patient to carry
out the treatment program
Any known allergy to retinoid class drugs
Concurrent treatment with local or topical therapy such as Vitamin A, cryotherapy, radiation
therapy, intralesional injection or photodynamic therapy for any indicator lesion

Locations:

Anderson Clinical Research - New York Stone Blacka, New York, NY, (212) 973-1156,
Fax 212-599-2257
Center for Quality Care Edward McKeithan, RN, Tampa, FL, (813) 875-4048 ext. 229,
Fax 813-876-1610
Pacific Oaks Research Group Lynn Cambria, RN, Beverly Hills, CA, (310) 360-8800, Fax
310-360-8812
Houston Clinical Research Network Stephen Garcia, RN, Houston, TX, (713) 830-3012,
Fax 713-528-2984
Oncology and Hematology Association Barbara Mathews, RN, Philadelphia, PA, (610)
617-8843, Fax 215-893-7461 henry@jimmy.harvard.edu



To: Russian Bear who wrote (14573)2/11/1998 8:46:00 AM
From: Henry Niman  Respond to of 32384
 
I believe that this is the AIDS Consortium protocol. It looks just like the LGND protocol, but I think that the original protocol also looked at immunological markers. This site doesn't give the detail for the protocol's objective and I haven't found the NCI version yet. The immunological parameter end point may have been modified or eliminated as more patients were placed on PIs. This protocol has a different number and the partial list of centers seems to be more in line with what would be expected from a government sponsored AIDS Consortium trial:

KS Treatment: ALRT1057 Oral
Capsules (2)

Last updated:05/29/1997

Title:

AMC002: A Phase II Evaluation of Oral ALRT1057 in Patients with AIDS-Related Kaposi's
Sarcoma

Purpose:

To see if oral ALRT1057 (also called PANRETIN or 9-cis retinoic acid) is safe and well tolerated
and to see if it is effective in treating KS lesions in AIDS patients.

About the study:

This is a dose-escalation or dose-ranging study. This means that patients will enter the study taking
the lowest dose of oral ALRT1057. The dose will gradually be increased over time until the
maximum dose that researchers plan to study has been given. All patients will receive oral
ALRT1057. There are no placebos in this study. Oral ALRT1057 is a capsule and taken once a
day. Study visits are every two weeks and the study lasts 16 weeks. If the study remains open and
active, patients may continue treatment for as long as the treatment is considered to be of clinical
benefit and has not shown severe side effects.

Required:

CD4 cell (T-cell) range: not applicable
HIV positive
At least 18 years old
Diagnosis of KS proven by biopsy. Patients must have a minimum of six skin lesions, three of
which are raised, and have been present for at least 30 days or measure at least 1.0 cm
Must have been on approved antiretroviral therapy for at least six weeks prior, during, and at
least one month after drug discontinuation

Not Allowed:

Women who are pregnant or breastfeeding
Systemic treatment for KS within 30 days of study entry
Systemic treatment with Vitamin A (more than 15,000 IU per day) or other retinoid class
drugs within 30 days of study entry
Previous treatment of study (indicator) lesions with any local or topical therapy within 60 days
of study entry
Current serious illness or infection which would interfere with the ability of the patient to carry
out the treatment program
Any known allergy to retinoid class drugs
Concurrent treatment with local or topical therapy such as Vitamin A, cryptherapy, radiation
therapy, intralesional injection or photodynamic therapy for any indicator lesion

Locations:

Massachusetts General Hospital - AIDS Cancer Ctr. Walter Howard, PA-C, Boston, MA,
(617) 724-9189, Fax 617-726-4319
LAC-USC Medical Center Miki Ilaw, RN, Los Angeles, CA, (213) 343-8271, Fax
213-226-2083
UCSF AIDS Program at SFGH/ICTG Sean Carnahan, San Francisco, CA, (415) 476-9296
ext. 301, Fax 415-502-5152 scarnahan@sfaids.ucsf.edu
Boston Medical Center Ruth Haivanis, RN, Boston, MA, (617) 534-5404, Fax
617-534-3534
Beth Israel Deaconess Medical Center - Oncology Jocelyn Bresnahan, RN, Boston, MA,
(617) 632-8528, Fax 617-632-7217
UC Davis Cancer Center Cheri Koppe, Sacramento, CA, (916) 734-3604, Fax
916-451-7551
AIDS Oncology Practice at UCSF / Mt. Zion Barbara Klencke, MD, San Francisco, CA,
(415) 567-5581, Fax 415-567-5584 barbara_klencke@quickmail.ucsf.edu



To: Russian Bear who wrote (14573)2/11/1998 8:50:00 AM
From: Henry Niman  Read Replies (1) | Respond to of 32384
 
RB, Looks like investors agree that the news is good. LGND's bid is creeping up (13 3/16) as is its ask (13 1/4). It's still early and of course LGND is still very cheap, although its recent move up was significant.