Johnson & Johnson (JNJ), Dendreon Corporation (DNDN) – Tackling Cancer: Prostate Cancer’s Biggest Current and Upcoming Players

  • Xtandi — Described as a “once-in-a-blue-moon approval” by the Fool’s Brian Orelli, Xtandi, developed by Medivation Inc (NASDAQ:MDVN) and Astellas Pharma, was approved three months early by the FDA after the oral pill — which, like Zytiga, targets male testosterone levels — improved median overall survival to 18.4 months from the 13.6 months witnessed with the placebo. One noticeable difference between the two drugs as pointed out by The New York Times, which may give Xtandi an edge, is that it doesn’t need to be given in combination with prednisone to lessen its side effects, unlike Zytiga. On the flip side, at $5,500 per month, Zytiga is noticeably cheaper than Xtandi,which runs $7,450 per month.
  • Provenge — When cellular immunotherapy treatment Provenge, developed by Dendreon Corporation (NASDAQ:DNDN) was approved in 2010, it was expected to change the face of advanced prostate cancer treatment. The three-course treatment involves removing immune cells from a patients’ blood, exposing them to a commonly found cancer protein, and then reinjecting them into the patients’ prostate with the expectation that they’ll attack the prostate cancer cells. In clinical trials, median overall survival time rose 4.1 months to 25.8 months versus 21.7 months for the placebo. Unfortunately for Dendreon Corporation (NASDAQ:DNDN), sales have lagged because its $93,000 price tag has made physicians and patients leery of potentially not being reimbursed. Insurers, as well, have been slow to latch onto the treatment.
  • Jevtana — Sanofi SA (ADR) (NYSE:SNY)‘s Jevtana, an IV-administered chemotherapy that’s combined with prednisone, has largely been pushed to the back burner in recent years by Zytiga and Xtandi, but it’s still worth mentioning. In trials, Jevtana boosted median overall survival by 2.4 months to 15.1 months. Like Xtandi, Jevtana targets treatment through hormone control and, at the time, was also approved three months early. However, with growing median overall survival times and all-oral medications available, Sanofi’s drug has fallen out of favor.
  • What’s coming down the pipeline
    Now that we’ve got an idea of what’s already available to treat metastatic castration-resistant prostate cancer, let’s have a look at some upcoming treatments that may steal the spotlight in the coming years.

    • Cometriq — Late last year, Exelixis, Inc. (NASDAQ:EXEL) received its first drug approval in Cometriq for the treatment of metastatic medullary thyroid cancer, or MTC. The drug, in trials, nearly tripled the median overall survival rate relative to the placebo, so I’ve been very eager to see how this would translate over to other diseases. Currently, Exelixis is recruiting for its Comet-1 and Comet-2 prostate cancer trials utilizing Cometriq for patients as a second, and potentially, third-line, treatment. In mid-stage trials, Cometriq (previously cabozantinib) demonstrated strong growth curbing clinical activity, especially in patients that developed bone metastases.
    • Radium-223 dichloride — Despite sounding like an ingredient to a nuclear bomb, this experimental drug that targets bone metastases in similar fashion to Cometriq and was developed by Bayer and Algeta, is currently under a priority review by the FDA. In trials, Radium-223 improved median overall survival to by nearly three months to 14 months as compared to 11.2 months for the control arm.