JNJ

Big wheels keep on rolling.....DNDN will be out of business by Christmas. Pill versus 96K joke. Adios

 

Add in all the litigation. Christmas is generous.

 

Some facts:

-JNJ said today that extension of survival using Zytiga pre-chemo was not statistically significant.

-78% of Provenge patients pay zero for Provenge. However most Zytiga pateints pay hundreds of dollars per month over the course of treatment. Same will be true for MDV3100.

Zytiga and Provenge have different Methods of Action so it makes sense to take both Provenge and Zytiga or MDV3100 if you want to maximize your life expectency. It is better to take Provenge first while the immune system is still strong.

Provenge has the fewest side effects and the greatest improvement in survival at 4.1 months improvement in medium survival.

 

you better have a strong study showing a significant increase in survival with combo. No payer will payout 93k plus cost of other drugs without it. And it can’t be the fraud study with Abi that is merely design to bury the PSA issue. That study is crap another dndn smoke and mirrors study

 

Sir, this board is about DNDN. Dendreon could have the greatest cure for cancer there ever was but if it cant be profitable there wont be employees and there wont be a company. DNDN will never turn a profit.

 

Lets face the facts...men will go from anti-androgen therapy...followed next by abiraterone...then docetaxel...then MDV3100.

Notice I dont have our own drug in the mix here, simply because urologist (yes...they will keep these patients longer now like they always have) will treat with Zytiga until patients they manage develop "pain". Once that happens...they will punt to the med onc.

The 5% SOM we have right now will drop to 1%. Lovely!!!

 

I wasn't talking about combo. These drugs will be taken sequentially. Reimbursement will not be an issue under these circumstances, especially with Medicare. Provenge will be taken first as soon as the patient fits the label.

 

Interesting. Issue with Provenge is Production and Zytiga's Pred will be an issue. Other issueis the cost. Last but more important issue is, what is right for the patient? As long as Zytiga's has shown PFS they will be used before Provenge. After that if one can Produce the Provenge, then yes, Provenge may be used. We need to see data showing if Provenge gets used after Abiraterone then does it still increases Survival. That is doubtful due to Steroid use. Also, most likely by the time patients are done with Abiraterone or Medivation, they will be symptomatic and not eligable for Provenge. Again, Dendreon has to show if Provenge is used before Abiraterone or Medivation, it still contributes to OS. Hypothesis does not work for a therapy such as Provenge that has an unknown and unproven Mechanism of Action.

Other therapy to watch for, is Alpharadane, again this would be used before Provenge and due to its radioactive property, most likely will be effecting immune system in a negative way and again there is data needed.

My prediction would be: MDV 3100 followed by Taxotere and then Cabazitaxol or second chance of using Zytiga or MDV.

Alpharadiane can be used before Taxotere or in combined with MDV or Zytiga. Due to known MOA, one can use hypothesis in this case and complete the small trial as well.

Unfortunately for Provenge, this maybe offered in small number of centers for patients who don't want or can not receive other therapies. Very, very small population.

In case of Ex-USA us for Provenge, let's get real. No way European's and their agencies pay for Provenge when there will be other easier and most likely cheaper therapies will be available.

Too bad, Dendreon blow it by hiring commercial teams who had no idea what they had. Too late now. Bye bye Dendreon.

 

You're back man. I missed your insights for a few days. You win all scientific debates and most legal debates. Most science people dont know much about anything else. For instance ex-ceo is a doctor but when it came to business he was clueless and resorted to crime, stupidly thinking he would never get caught. You know science and some business and legal too. You're an anomaly.

 

Well done post #8 bottom line cogs way too high for profit drug to expense and logistically complicated at best a last resort. Sad this platform should have been the future and gold standard for patients. Needed a real sales team and a commercial CEO by the way he never completed his residency so he's not a urologist has a degree in medicine never finished

 

Post 8 guy is one of the best voices of truth since the "Dear Mitch" guy. There are going to be indictments with the help of these fellows. No matter what they both admit or dont admit I am sure they have spoken to authorities.

 

Friends, please understand the perspective of someone who has had cancer and has had a close family member die from cancer very quickly. This is about what is best for prostate cancer patients who will most likely die from their cancer, not what is best for your own personal agenda, whatever it may be. Most cancer patients want as many LIFE EXTENDING treatments in them as possible, assuming the safety profile is sufficent. The landscape of mCRPC therapy will change for the better in the coming years. This is fabulous for for these men who suffer from PCa and their families who suffer with them. In my opinion and my hope is that when a man is diagnosed early enough with asymptomatic mCRPC, he will be offered Provenge and MDV3100 concurrently due to different MOA's. As he progresses through these treatments (ie. PSA Rise, bone progression, symptomatic disease), he will then be offered Zytiga/Prednisone with concurrent use of Docetaxel which also is also prescribed with Prednisone. As he continues to progress, Cabazitaxel is available. Alpharadin will eventually find its niche. Provenge COGS will need to be reduced to a more acceptable level. The company knows this and is working on it. The company also realizes that sales must increase and they are also working on this (they have been increasing every quarter if you haven't noticed). If it were my PCa, at whatever stage, I would opt for provenge as soon as possible (and if paid for). What would the downside be? Three infusions, little side effects, done for life, accept for some potential boosters eventually. Really? no horse pill three times a day with prednisone, and $5G per month for who knows how long? Anyway, all of these treatments should be used in sequential order to do what is best for patients. The only catch will be when the govt and commercial payer say "they are no longer willing to allow patients who paid or are paying into the system to have a potentially life extending treatment". I don't look forward to that day in the richest country in the history of the world.

 

Sorry friend,

I am sorry for your losses in life and I respect your post. You are writing it to the wrong people. We are people who work for a company and post opinions on a board. Many of us have been touched with cancer as well. We have no affect on what ultimately happens with Provenge.

The best place for you to discuss what you have written in your post is with the ex-CEO of this company who also used to tell people he was in this business because of cancer in his own family.

If anyone has set prostate cancer patients back it was this ex-CEO and his disease of greed who refused to partner so provenge could be marketed with proper synergies and economies of scale that partnering with big pharma would have brought.

He wanted it all. Being a 50 millionaire wasn't enough. He wanted 100's of millions. His disease did this company in. His disease did shareholders and employees in. If Provenge was going to be a success his disease ruined the only window of time in which it could have been have been marketed before all this competition. His disease ruined his own life which is now going to be fraught with legal difficulties probably for the rest of his life.

Cancer is a disease. Cancer kills. Greed is a disease. Greed destroys.

 

A country in debt by trillions of dollars is not a rich country.

If you take your own personal balance sheet and you find that you have negative net worth do you consider yourself rich?

At some point we have to do what is practical. Provenge was never really talked about in terms of cocktails or using it in conjunction with other medications or sequentially. It used to be talked about as end of life last resort and to hopefully extend lives. If people can personally afford to do cocktails and use provenge and then sequentially other drugs then great, but at some point the American people can not foot the bill of hundreds of thousands of dollars for each person who has prostate cancer who might get 4 months added to their life, might get a year, might get 2. The math and the economics just does not work. If you want to call that death panels, so be it. I call it saving the future of America.

 

Believe me, i understand your point of view, and we are all entitled to our opinions. I will say that it will not be easy when you tell your Dad and best friend that you don't think he should have that expensive drug, that he paid into the system for, so that he could potentially live another 3, 4, or 5 years with your mom. And maybe even a chance to see his grand kids grow to be men or women. All because you want to save the future of the American economy. It is very patriotic though.

 

Reply 12;

Everyone has been touched with Cancer. As you are stating, we should extent people's lives. Truly, we have to be objective. I am not sure if I have seen any data showing those who have received Provenge first followed by Zutiga and the rest of available therapies, live longer than those he did not receive Privenge.

Issue is, we know how Zutiga works, we see it's effect in PSA, Tumor, Pain and Overall survival. It's Mechanism of Action (MOA) has been proven. MDV 3100 is similar and has a proven MOA. Provenge is under question? According to one of the Previois posts, Dendreon has been holding to a very crucial data relating to the Genetic Profiling of patients who showed better OS. (HLA typing)
Anyone who has taken any immunology class will tell you that HLA typing in immune therapy are very important.

I do believe there will be a role for Provenge in CaP but not in it's current FDA label. If there is a place in earlier disease then Dendreon needs to show that with data and a good trial design in a large population. That would be years away. There is no need to be emotional, we all have lost relatives and friends to Cancer but we have to stay objective and treat patients with what we know is best for him.

It is hard to justify a use of a drug/therapy such as Provenge when there are other better drugs that we know how they work, we can see how they work and stop and switch to a different therapy if they dont work. You can not say that for Provenge. You have to pay and Pray and hope that worked. Well, when there was nothing else on that space, you could call it the only hope but it appears that now there is another player in the same space with known and effective mechanism of action (MOA) and that player for now is Zytiga and most likely near future also MDV 3100. Then it makes sense to start with them before thinking about a therapy such as Provenge without the known MOA and a high price tag.
Please don't let Dendreon use you as a patient or family member. For them all matters is their pockets and nothing else.

 

Post 15:

300,000,400,000,500,000 is much more than what 99% of Americans pay into Medicare. This cant be sustained.

If certain cocktails of all kinds of drugs are going to cost this much to possibly extend lives by 4,5,6, 7 months a year and have some longer outliers and some shorter outliers then the government will not be able to do it and should not do it. It would not be me telling my father or uncle no, it would be the government doing so. I have had these discussions with relatives and they agree. This isnt about patriotism. This is about reality and practicality. This would not be sustainable.

 

So Provenge should only be used when a scientist can define the EXACT MOA, despite multiple trials that provide evidence of life extension?

"Sir, I am not going to offer you Provenge today because I have not been told how it works"

"but I read somewhere that the men that got Provenge lived longer? Is that not true?"

"No, it's true. They did live longer, but until I know how they live longer, it is not the right treatment for you.

"But doctor, isn't it your job to give me as many treatments as possible to keep me alive as long as possible with a high quality of life?"

"Why yes, but I believe the nasty drug company snowed the FDA with a couple of trials that proved that you may live longer and have minimal side effects. And they claim it stimulates your immune system, but they don't they know exactly how."

"but the men that got it lived longer?"

"so they say..."

"Oh, OK. Would you take Provenge if you had prostate cancer?"

"yes"

"OK, thanks for your opinions. I'm going to find another physician to help me with my cancer."

 

I agree with you there. The mechanism of action is unknown for large numbers of commonly prescribed drugs including statins, most psychotropic /psychiatric drugs like Lithium, acetaminophen and Lysodren (a common chemotherapy drug) and… general anaesthetics. Would it be ethical to stop using those on surgical patients?

The gold standard for a cancer drug is Overall Survival and Provenge blows the competition away in that regard.

Provenge is just in the first inning of a nine inning game. They recently fired their manager and brought in a seasoned veteran (John Johnson) to manage the next eight innings.

 

Provenge may be a fine drug but there wont be an 8 more innings for Dendreon. The next inning is legal matters. After that a takeover late in 2012 for a measly premium. The company taking over will be stuck with billions in civil liability. Hopefully Provenge succeeds under a new umbrella. This company had the drug and squandered it because all they were interested in was money for themselves.