According to the American Cancer Society, more than 60,000 new cases of thyroid cancer will be diagnosed in the U.S., and about 1,850 people are expected to die from the disease in 2013. Limited treatment options are available for advanced thyroid cancer — known as medullary thyroid cancer, or MTC — and Cometriq from Exelixis, Inc. (NASDAQ:EXEL) is among them. Cometriq is well accepted in the treatment of MTC and also may be used for multiple indications due to its unique biological properties. While opinion on Exelixis’ potential are mixed, there are reasons to keep this biotech stock on your radar.
Other options in the market are limited
Besides Cometriq, there are two more products against MTC — Caprelsa from AstraZeneca plc (ADR) (NYSE:AZN) and Nexavar from Onyx Pharmaceuticals, Inc. (NASDAQ:ONXX).
Caprelsa is indicated for advanced MTC. The product was approved back in 2011 and has yet to realize its peak sales potential estimated at between $120 million and $200 million by various analysts. Last year, it made less than $30 million. AstraZeneca, already beset with loss of exclusivity of several brands, might be focusing on drugs that have more potential to bring in sales.
The other drug, Nexavar, approved for liver and kidney cancer, is under evaluation for MTC therapy. According to Exelixis’ last 10-Q, the drug is prescribed off-label for MTC and is also a competitive threat. Nexavar is well-accepted across the U.S. for its approved indications, and has been around for a while. Its recent quarter sales was of $81.8 million, up by 13% over the prior year. The additional MTC indication could help boost sales of the drug. If the product is approved early, that will negatively affect Cometriq’s market potential. Right now, however, Cometriq is one of the few contenders in the MTC race.
Opportunity for Exelixis in MTC
Exelixis expects an average of 1,200 patients for Cometriq therapy in the U.S., each generating revenue of around $9,900 per month. The company expects to generate peak sales of approximately $12 million to $15 million from the U.S. Cometriq had sales of $4 million in the most-recent quarter. So, if these expectations are correct, sales should start to slowly ramp up in the coming quarters.
The company expects to expand the usage of cabozantinib, the active ingredient of Cometriq, in other solid tumors. The ongoing COMET trial, with likely completion in 2014, has two essential phase 3 studies for the treatment of a rare disease known as metastatic castration-resistant prostate cancer, or CRPC. Of this, COMET-1 is to study the efficiency of cabozantinib versus prednisone, and COMET-2 is for comparative study against mitoxantrone and prednisone. In addition, the initiation of METEOR study is a phase 3 trial to evaluate the efficacy of cabozantinib in patients with metastatic renal cell cancer. These additional trials may give wider opportunity for cabozantinib, and on approval, this will enhance the company’s performance.