Release date: 2016-07-01
This morning, Tesaro, a biotech company on the edge of Boston, USA, fired more than doubled after the stock opened, from $37 to $77. All of this was due to the release of Phase III clinical trial data of its new anti-cancer drug Niraparib. The results were unexpectedly good and will definitely be available soon.
This is the normal state of the biopharmaceutical circle, with high risks and high returns. Before any new drug clinical results come out, no one dares to make a ticket. If it fails, it is worthless. If it succeeds, the stock price will skyrocket. Before today, Tesaro's share price has actually fallen by 33% in one year, and the salted fish turned over overnight. I don't know how many "experts" will jump out and say, "I have already let you copy the bottom, don't listen to me!"
Talking about money hurts feelings, you still talk about science.
What is it?
What kind of medicine is this?
It is called Niraparib and is a targeted drug for the PARP gene, mainly targeting cancers with BRCA1/2 mutations, such as ovarian cancer and breast cancer. By the way, it is an oral medicine, so the patient can eat it at home on time, without going to the hospital for infusion.
How good is it?
Published today is the third phase of clinical data for advanced ovarian cancer, and patients are relapsed after chemotherapy, there is no other good way. The results showed that for ovarian cancer with BRCA mutation, oral Niraparib was administered once a day, with a median progression-free survival time of 21 months, compared with 5.5 months for the control group (using chemotherapy).
“Progressive Survival†is one of the most commonly used indicators for cancer clinical trials. It describes not the overall survival time of the patient, but the time to effectively control the tumor. During this time, the tumor may be reduced or may not change. In short, Without deterioration, the patient's living conditions will be better and the quality of life will be high.
21 months to 5.5 months, almost 4 times!
Of course, the patient's overall survival time will generally significantly exceed the "no progression of survival", which means that patients with BRA mutations using Niraparib can survive for an average of more than 21 months. For patients with advanced ovarian cancer who have relapsed, this is Very amazing.
Undoubtedly, once the drug is on the market, doctors and patients will not hesitate to choose. This is the root cause of the money and stock company's skyrocketing.
The underworld is most afraid of chaos
Just now, Niraparib belongs to the PARP inhibitor, which is a kind of targeted drug against the PARP gene. It is not effective for any cancer, but is mainly used for patients with BRCA1/2 gene mutation. This is reflected in the current saying. The cancer "precise medical".
Why is PARP particularly effective against BRCA mutant cancer cells?
PARP and BRCA are the two main genes responsible for repairing DNA mutations in cells, and they are the "left and right protection methods" that protect our cell health. Due to the influence of the environment, DNA mutations occur in our body anytime and anywhere. However, due to the existence of these two protection methods, more than 99.9999% can be successfully repaired after DNA mutation, otherwise the incidence of cancer will be much higher than now. .
However, some people have mutations and inactivity due to congenital or acquired factors. Therefore, their DNA mutations have a much reduced repair probability, and they will accumulate more gene mutations. The probability of cancer in this group is also high. greatly increase.
For reasons that are not fully understood, BRCA mutations primarily affect women, especially leading to increased ovarian and breast cancer. The probability of breast cancer has increased from less than 10% to 55% to 65%. The probability of ovarian cancer increases from 1% to up to 39%.
BRCA mutations are a double-edged sword for cancer cells.
On the one hand, it is an advantage because it accumulates genetic mutations faster, evolves faster, is more prone to drug resistance, and so on.
On the other hand, it is a disadvantage, because there are no BRCA cancer cells, and if there is no PARP, the ability to repair DNA is completely lost, which leads to extreme confusion, and soon the cells will die, even if the cancer cells do not. . Since there is no BRCA, cancer cells become very dependent on PARP. A little chaos is an advantage, and no one can stand it.
Who is the most important to emphasize organizational discipline? Not the ordinary people, but the underworld.
Cancer cells are like triads. They like to get some "unruly" ability through BRCA mutations. It is usually very cool, but if BRCA+PARP is not available at the same time, it becomes "suicidal madness." Underworld, pawn.
With PARP inhibitors, BRCA-mutated cancer cells are completely unable to repair DNA and therefore collapse, while normal cells have the ability to repair DNA because of the presence of BRCA, but PARP can only repair DNA, but it can survive. This is why PARP inhibitors act as targeted drugs to selectively kill BRCA mutant cancer cells.
Niraparib should be the second listed PARP inhibitor. Last year, AstraZeneca has launched the PARP inhibitor Olaparib (also known as Lynparza), which is expected to be used for BRCA-mutated ovarian cancer because of its significant effect. $2 billion a year!
There is no doubt that this is a huge market, so there are several similar drugs in the back, and there are Rucaparib (Clovis) and Talazoparib (Medivation) in the United States. We also have China, the "Baji China" BGB-290, which has been in the forefront, has already demonstrated its efficacy in clinical trials in Australia. It is hoped that clinical trials will be carried out in China as soon as possible to benefit patients.
Although these drugs are somewhat different in some characteristics, the mechanism is roughly the same, and in the end, they will certainly grab the same market. From the perspective of the company's business, it is a big challenge, but for patients, it is certainly a good thing to choose more. Moreover, such competition should lead to a decline in drug prices, an increase in the weight of government negotiations, and ultimately hope that medical insurance can bear. Otherwise, tens of thousands of Chinese people can't afford it in a month.
Although PARP inhibitors are mainly targeted at breast cancer and ovarian cancer, other cancers also carry BRCA mutations, or other DNA repair defects. They theoretically use PARP-targeted drugs, which may also be good, including some prostate cancers. Fallopian tube cancer, pancreatic cancer, children with acute myeloid leukemia. Clinical trials for them are in progress and will wait and see.
The gospel of young women
The success of PARP inhibitors is especially important in young women.
About 1% of all breast cancers are BRCA mutations, but the proportion is much higher among young women under 40 years of age. It is not difficult to understand that cancer requires multiple genetic mutations, so it usually takes years to accumulate, but if BRCA mutations lead to accelerated mutations, these people are more likely to get cancer when they are younger.
Yao Beina, Chen Xiaoxu are young breast cancer patients, and later died. Probably, they are likely to carry mutations in the BRCA gene. If this is the case, using the current PARP inhibitors may have very different results. Unfortunately, they did not wait for such an opportunity.
Liu Qing, the 38-year-old president of Didi, also suffered from breast cancer. I admire her open courage and wish her a smooth treatment. In this case, she should definitely do the BRCA test, and the target drug can be better targeted regardless of the outcome.
At the same time, if young women have children, or are ready to give birth, these genetic mutations can also guide the need to do similar tests for their children in order to understand the risks.
Today's news, the most complicated emotion in my heart may be another young woman: Hollywood movie star Angelina. Julie.
The world's "sexiest woman", with hereditary BRCA1 gene mutation, predicts that 87% of her chances will be breast or ovarian cancer before the age of 70, so she made a preventive bilateral breast at the age of 37. Excision, 39 years old and ovarian resection, shocked the world.
Her actions have evoked countless people around the world to understand the BRCA gene mutation, hereditary cancer, cancer screening, and saved many people. It is definitely merit.
But she herself, or other similar mutation carriers, is the best choice for such a "strong man's broken wrist", and the scientific community has always been controversial.
First, because the 87% probability is not 100%, she does not necessarily get cancer, and the preventive resection is 100% damage to the body. For Julie, her biggest wish is to "take a child's college graduation ceremony," so she is not willing to take risks. This is a personal choice, nothing wrong.
A breakthrough drug like Niraparib brings another, more difficult question: Is it worthwhile if cancer is no longer a terminal illness?
When Julie made her decision, if she was sick, she was faced with surgery, chemotherapy, and the effect was general and the recurrence rate was high. Now, Niraparib has demonstrated that targeted drugs can help patients with advanced ovarian cancer with BRCA mutations, and even on average, they can live for two years at high quality even after the disease recurs. There are also new immunopharmaceuticals such as PD1 inhibitors, which in theory will have very good results for patients with BRCA1 mutations. New targeted drugs + immunologic drugs, and perhaps most of the BRCA mutant cancers will soon become chronic diseases.
Suppose Julie does not have surgery. At the age of 60, she really got cancer. It is already 20 years later. The progress of science is very fast. If there is a breakthrough in time?
Julie: If you can come back again, will you make the same decision?
Source: Pineapple Factor
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