Sutent given U.S. approval
Miracle Cancer Drug Extends Life With $48,720 Cost (Update1)
While about a third of those with GIST who switch to Sutent get no benefit, the drug has been a lifeline for thousands, Demetri said, often buying enough time for a new medicine to roll out of the targeted therapy pipeline.
Susan Farmer was a different case.
The company that developed Sutent, Sugen Inc., got its start in Redwood City, California, in 1991. Cancer treatment at the time had been largely unchanged for decades. Doctors bombed tumors with a toxic chemical mix and hoped for the best. They rarely got it, and patients suffered chemotherapy side effects including hair loss and debilitating nausea.
By 1989, scientists had identified a protein -- known as a kinase -- as the primary driver of angiogenesis: vascular endothelial growth factor, or VEGF. The discovery set off a race to isolate others and develop inhibitors.
Gen for Genetics
A solution required designing drug molecules so precise they could slip into the pockets of specific kinases without interfering with ATP. Sugen scientists bombarded cancer-driving proteins with synthesized chemical compounds to figure out which of them showed promise as kinase inhibitors.
By 1998, Sugen was “burning through about $100 million a year,” and running out of money for the clinical trials that are fundamental to bringing a drug to market, according to Peter Hirth, who was president at the time.
In May 2001, Novartis, based in Basel, Switzerland, secured FDA approval for Gleevec, which worked by knocking out the main molecular driver in chronic myeloid leukemia. Genentech was by then in trials with what it would call Avastin -- used today against five cancers -- and early results indicated it would prove that VEGF inhibitors could thwart angiogenesis.
Then Sugen tested it in a 2002 “basket trial,” so named because people with a variety of cancers took part. SU11248 was sent to oncologists worldwide, and in what Ullrich called a “lucky accident” a Paris doctor gave it to three kidney cancer patients. Two “had outstanding responses,” he said.
She changed her mind after a scan showed the tumors shrinking once more.
“Pfizer knows very well I can’t refuse to cover this drug,” Newcomer said in an interview.
‘More Expensive Treatments’
‘The Deep End’
As pharmaceutical companies continue to produce these and other “more advanced, and more expensive treatments,” U.S. cancer-fighting costs will rise faster than overall medical spending, according to the National Cancer Institute in Bethesda, Maryland. Cancer treatment spending rose 75 percent in the decade ending in 2004, to $72.1 billion, according to a 2007 NCI report, the latest data available.
Medicare already devotes about a quarter of its budget -- now $450 billion -- to care in the last year of life, according to the policy journal Health Affairs. As baby boomers age and fall under the U.S. tax-funded program, they’re ushering in a new era of spending.
That number might fall as researchers invent better diagnostics that let doctors more quickly identify a cancer’s genetic driver and make smarter drugs that cleanly knock out cancer drivers, according to Flaherty.