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More About New Revlimid Data Showing Elevated Risks Of Developing Secondary Malignancies With Prolonged Use

Home/More About New Revlimid Data Showing Elevated Risks Of Developing Secondary Malignancies With Prolonged Use

More About New Revlimid Data Showing Elevated Risks Of Developing Secondary Malignancies With Prolonged Use

Celgene shares plummet on Revlimid malignancy data

By Toni Clarke – BOSTON – Mon Dec 6, 2010
BOSTON (Reuters) – Celgene Corp (CELG.O) shares fell more than 9 percent on Monday after data was reported that showed an increase in the risk of secondary malignancies in certain patients taking its blood cancer drug, Revlimid, for extended periods of time…

We knew this much as reported by the Wall Street Journal yesterday.  Here’s more detail which might help clarify things from Reuters:

Brian Gill, a spokesman for Celgene, said the stock reaction is based on investor misunderstanding of the context for the data. He said about 8 percent of multiple myeloma patients who are alive after two years are at risk of developing a secondary cancer.

Moreover, if a patient receives a stem cell transplant, or receives a type of drug known as an alkylator, such as melphalan, the risk of developing a secondary cancer is eight times higher than if those elements are not included in the treatment.

In the trial reported on Sunday, known as CALGB, patients were either given a high dose of melphalan followed by a stem cell transplant followed by Revlimid, or were given melphalan, a stem cell transplant and a placebo.

The trial showed that patients in the Revlimid group had a 60 percent reduction in the risk of their disease progressing after four years. About 15 patients in the Revlimid arm developed a secondary cancer. While the exact types of cancer were not broken out, Gill said they were mainly other blood cancers such as acute myeloid leukemia. In the placebo group, 10 patients developed a secondary cancer.

“This is to be expected and within the normal 8 percent range,” Gill said.

Really?  Doesn’t an 8% risk of developing an additional type of cancer seem a bit high?

Results of a similar trial, known as IFM, were reported on Monday. Unlike the CALGB trial, patients in the IFM trial were also given a booster dose of Revlimid after the stem cell transplant. Patients in the Revlimid arm had a 50 percent reduction (the before mentioned trial I wrote about featured a 60% reduction) in the risk of their disease progressing after four years.

Seven patients in the Revlimid arm developed a non-blood cancer secondary malignancy compared with one in the placebo group. Ten patients in the Revlimid arm developed a secondary blood cancer, compared with two in the placebo group.

Gill said the figures were once again in line with the expected range.

So what happened to the stock by day’s end?  Here is Reuter’s analysis:

Still, Wall Street was not reassured. Unused to bad news from the biotech industry’s most popular company, investors sent the shares down 9.5 percent to $54.84 in midday trading.

Ouch!  Stock market reactions are a funny thing.  My article from earlier today about how well carfilzomib works when combined with Revlimid shows incredible promise!  Every single patient who was treated using this combination responded.  Every one! 

My guess is good news like this won’t move the Celgene stock price nearly as dramatically as the bad news about secondary cancers.

I had an elderly friend and fellow multiple myeloma patient, named Gene, who was warned, before taking melphalan, that he risked developing another form of blood cancer.  The melphalan worked.  And as expected, he did develop a secondary malignancy.

My friend has since passed away, so I can’t call and ask about specifics.  But doctors assured his wife at the time it was the myeloma which led to his demise–not his secondary blood cancer.

Here’s the thing.  I’m not a stock expert or a physician.  I’m a multiple myeloma patient, taking Revlimid 
monthly—and have been for close to four years.

My opinion is this:
It seems to me an 8% risk of developing another manageable cancer is a small price to pay for controlling a terminal one.  Cancer sucks!  Undergoing a stem cell transplant carries risks.  There are risks of developing blood clots, adverse allergic reactions and a number of other serious side-effects from taking chemotherapy. 

I guess I just look at this as one more serious, if not unexpected risk for staying alive.

Look—do you think I have never reflected about what all of the chemotherapy “poison” I take will eventually do to my body?  I have watched fellow patients wither and weaken and seemingly get eaten-up from the inside out—not so much from their cancer as the thalidomide, melphalan or cytoxan they were taking.

A wimpy case of leukemia doesn’t scare me—its the drugs I will need to take to control another cancer which is terrifying!

Feel good and keep smiling!  Pat