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To: NP1986 who wrote (38378)6/2/2012 5:13:43 PM
From: Biomaven   of 40275
 
My personal view is that Tivo will become the drug of choice for first line use, but others who I respect (including Sally of pharma strategy blog) disagree. You can argue about whether efficacy is better than Sutent or not (I personally think it is at very least no worse and possibly better) but you can't argue about tolerability. So why wouldn't you start with the most tolerable drug, and reserve Sutent for 2nd line? Makes life easier for the oncologist too - fewer dose interruptions and dose reductions.

Peter

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From: ariadough6/4/2012 7:08:02 AM
   of 40275
 


ARIAD Announces Updated Data from Pivotal PACE Trial of Ponatinib, Its Investigational pan-BCR-ABL Inhibitor ~ Robust anti-leukemic activity in CML patients who have become resistant or intolerant to available tyrosine kinase inhibitors

~ 54 percent major cytogenetic response and 30 percent major molecular response reported in heavily pretreated chronic-phase CML patients

~ Investor meeting and webcast to be held today at 12:00 p.m. (CT)

Press Release: ARIAD Pharmaceuticals, Inc. – 4 minutes 58 seconds ago







Companies:
Ariad Pharmaceuticals Inc.





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ARIA 15.71








CHICAGO & CAMBRIDGE, Mass.--(BUSINESS WIRE)-- ARIAD Pharmaceuticals, Inc. ( ARIA) today announced updated clinical data from the pivotal PACE trial of its investigational pan-BCR-ABL inhibitor, ponatinib, in patients with chronic myeloid leukemia (CML) or Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL), who are resistant or intolerant to dasatinib or nilotinib or who have the T315I mutation. These data show that 54 percent of chronic-phase CML patients in the trial, including 70 percent of patients who have a T315I mutation, achieved a major cytogenetic response. ARIAD expects to file for regulatory approval of ponatinib in the U.S. and the EU in the third quarter of 2012 based on these clinical data.

The PACE trial data are being featured today at 9:00 a.m. (CT) in an oral presentation at the 2012 American Society of Clinical Oncology (ASCO) annual meeting taking place in Chicago, IL.

“The findings from the global PACE trial of ponatinib confirm its impressive anti-leukemic activity in patients with CML at all stages who are resistant or intolerant to dasatinib or nilotinib, or who have the T315I mutation for which there are no currently available treatments,” stated Jorge Cortes, M.D., professor and deputy chair, Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX.

“Clinical responses to ponatinib were observed in patients regardless of their mutation status or disease stage,” he added. “Of particular importance, responses to ponatinib appear to be durable, with 93 percent of chronic-phase CML patients projected to remain in major cytogenetic response at one year, clearly highlighting the potency of ponatinib.”

Updated Results Presented at ASCO

    Trial Design
      Efficacy data were reported at ASCO on 444 treated patients in six pre-specified cohorts at 45 mg of ponatinib administered orally once daily. Patients were assigned to a cohort based on their phase of disease (chronic-phase, accelerated-phase or blast-phase CML/Ph+ALL) and T315I mutation status (with or without the mutation). Ninety-three percent of the patients in the trial had received at least two tyrosine kinase inhibitors prior to enrollment. Fifty-eight percent of the patients had received three or more tyrosine kinase inhibitors prior to enrollment. Chronic-phase patients had bone marrow assessments approximately every three months for determination of cytogenetic response. Findings on each of the 444 patients treated in the study were based on at least six months of available response data. The T315I mutation status was determined using a standardized Sanger sequencing test by MolecularMD in Portland, OR.
    Chronic-phase CML patients evaluable for cytogenetic response (N=267)
      Based on assessment of all evaluable chronic-phase patients in the trial, 54% (144 of 267) achieved a major cytogenetic response (MCyR), with 44% achieving a complete cytogenetic response (CCyR). The median follow up of the chronic-phase CML patients is 10.1 months. MCyR is the primary end-point for chronic-phase CML patients in this pivotal trial of ponatinib. Of the 64 evaluable chronic-phase CML patients with the T315I mutation, 70% (45 of 64) of these patients achieved a MCyR, with 66% achieving a CCyR. The MCyR rate in evaluable chronic-phase patients without the T315I mutation was 49% (99 of 203). Thirty percent (79 of 267) of chronic-phase patients achieved a major molecular response (MMR). Of 64 chronic-phase patients with the T315I mutation, 50% (32 of 64) attained a MMR. MMR is the primary end-point in ARIAD’s planned Phase 3 trial of ponatinib against imatinib in newly diagnosed CML patients that is expected to begin in the 3Q of 2012.
  • Responses in chronic-phase patients who had received only one prior TKI (N=21)
    • There were a total of 21 chronic-phase patients treated with ponatinib in the PACE trial who had previously received only one tyrosine kinase inhibitor (TKI). Thirteen of these patients had previously been treated with imatinib only and eight had previously received either dasatinib or nilotinib. Of the 21 patients who received ponatinib following treatment with only one prior TKI, 86 percent (18/21) achieved a MCyR.
  • Advanced phase CML patients evaluable for response (N=177)
    • Sixty percent (39 of 65) of accelerated-phase patients in the resistant or intolerant cohort achieved a major hematologic response (MaHR). Fifty percent (9 of 18) of accelerated-phase patients with the T315I mutation achieved a MaHR. MaHR is the primary end-point in accelerated and blast-phase CML or Ph+ALL patients in the trial.
    • Thirty-five percent (17 of 48) of blast-phase CML or Ph+ALL patients in the resistant or intolerant group achieved a MaHR. Similarly, 33% percent (15 of 46) of blast-phase CML or Ph+ALL patients with the T315I mutation also had a MaHR.
    • Thirty-four percent (22 of 65) of accelerated phase patients and 27% (13 of 48) of blast phase or Ph+ALL patients in the resistant or intolerant cohorts achieved a MCyR. Twenty percent (13 of 65) of patients in accelerated phase and 23 percent (11 of 48) of patients in blast phase or Ph+ALL in this same group achieved a CCyR.
    Safety profile (N=449)
      Updated safety data show ponatinib to have a favorable profile in these heavily pretreated patients. The most common adverse events considered related to ponatinib included thrombocytopenia (in 35% of patients), rash (32%), dry skin (30%), abdominal pain (22%), and headache (18%). Elevated serum lipase, fatigue and arthralgia were observed less frequently. The incidence of pancreatitis across the study and including all grades was 6%. Pancreatitis was previously determined to be the dose-limiting toxicity of ponatinib in the Phase 1 trial.
“These updated findings of the PACE trial show beneficial responses and an increasing molecular response rate to ponatinib,” said Frank G. Haluska, M.D., Ph.D., senior vice president and chief medical officer of ARIAD. “Importantly, these data provide clear evidence of a favorable safety and tolerability profile of ponatinib in resistant or intolerant CML patients. The adverse event profile is similar to what was seen in the earlier Phase 1 study of ponatinib, although the incidence of pancreatitis is less in the PACE trial,” added Dr. Haluska.

Investor Meeting Today at 12:00 p.m. (CT)

ARIAD will hold an investor meeting and webcast at 12:00 p.m. (CT)/1:00 p.m. (ET) today, Monday, June 4, 2012 to review these data being presented at ASCO. The event will feature Jorge Cortes, M.D., professor and deputy chair, Department of Leukemia, The University of Texas M.D. Anderson Cancer Center. This event is being held at the Chicago Hilton Hotel for ARIAD’s research analysts and for institutional investors attending the ASCO conference and will be webcast live on the investor relations page of the Company's website at http://investor.ariad.com.

A replay of this investor event will be available on the ARIAD website approximately three hours after the presentation and will be archived for four weeks. To ensure a timely connection to the live webcast, participants should log onto the webcast at least fifteen minutes prior to the scheduled start time.

About CML and Ph+ ALL

CML is characterized by an excessive and unregulated production of white blood cells by the bone marrow due to a genetic abnormality that produces the BCR-ABL protein. After a chronic phase of production of too many white blood cells, CML typically evolves to more aggressive phases such as accelerated or blast crisis. Ph+ ALL is a subtype of acute lymphoblastic leukemia that carries the Ph+ chromosome that produces BCR-ABL. It has a more aggressive course than CML and is often treated with a combination of chemotherapy and tyrosine kinase inhibitors. Because both of these diseases express the BCR-ABL protein, this would render them potentially susceptible to treatment with ponatinib.

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To: ariadough who wrote (38382)6/4/2012 10:27:36 AM
From: Biomaven   of 40275
 
There were a total of 21 chronic-phase patients treated with ponatinib in the PACE trial who had previously received only one tyrosine kinase inhibitor (TKI). Thirteen of these patients had previously been treated with imatinib only and eight had previously received either dasatinib or nilotinib. Of the 21 patients who received ponatinib following treatment with only one prior TKI, 86 percent (18/21) achieved a MCyR.
This is very impressive. Dasatinib and Nilotinib in 2nd line (after Gleevec failure) yield around 60%.

In general, the results in the full set of chronic phase patients are also very impressive - more like what you would expect in front line.

As a more direct comparison, the other agents in 3rd line yield MCyR rates in the 20-25% range compared with the 54% rate seen here.

Peter

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To: Biomaven who wrote (38383)6/4/2012 2:37:54 PM
From: Arthur Radley   of 40275
 
ARQL got a bad draw of the cards by presenting on Saturday at ASCO. All the attendees where attending the fireworks at BMY, J&J, and Medivation......so ARQL was overlooked at the party, but finally today the good folks at Oppenheimer got around to putting a little wind at our back...

Oppenheimer Discusses Compelling Data from ArQuel (ARQL) at ASCO

8:16 am ET 06/04/2012 - Street Insider


Oppenheimer commented on ArQule (NASDAQ: ARQL) following this weekend's ASCO noting compelling tivantinib ph.II 2nd-line HCC results.

The firm comments, "The ph.II trial met the primary PFS endpoint, and tivantinib demonstrated significant TTP/PFS/OS benefit (HR=0.43/0.45/0.38) vs. placebo in the high c-MET expression subpopulation (~50% of pts), which, importantly, was a prespecified analysis. Notably, grade ¾ neutropenia was low (6%) at the 240mg, go-forward dose. Based on these results, we see a clear path to ph.III success, but ARQL currently reflects no value for this opportunity."

The firm maintained their Outperform rating and price target of $11.00

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To: Biomaven who wrote (38381)6/4/2012 11:54:46 PM
From: freelyhovering   of 40275
 
Any studies indicating that taking Provigil or Nuvigil has any effects on preventing or controlling Alzheimer's? Coffee seems to help. Why not Provigil?

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To: freelyhovering who wrote (38385)6/5/2012 10:19:49 AM
From: Biomaven   of 40275
 
Doesn't seem to be much in the way of research. Here's a review abstract:


nn Pharmacother. 2010 Oct;44(10):1624-32. Epub 2010 Aug 24.
Use of psychostimulants in patients with dementia.
Dolder CR, Davis LN, McKinsey J.
SourceWingate University, NC, USA. cdolder@wingate.edu


AbstractOBJECTIVE:To review the efficacy and safety of psychostimulants for negative behavioral symptoms (ie, apathy, excessive daytime sedation) and cognition in patients with dementia.

DATA SOURCES:Literature was accessed through PubMed and MEDLINE (1966-June 2010), using the terms stimulant, psychostimulant, methylphenidate, dexmethylphenidate, amphetamine, dextroamphetamine, lisdexamfetamine, atomoxetine, modafinil, armodafinil, dementia,Alzheimer disease, vascular dementia, Lewy body dementia, mixed dementia, frontotemporal dementia, therapy, treatment, and therapeutic. Additional references identified from the initial search were reviewed.

STUDY SELECTION AND DATA EXTRACTION:All relevant clinical trials published in English and involving primarily older adults with dementia were included. Case reports, review articles, and other preclinical literature were included as appropriate.

DATA SYNTHESIS:Psychostimulants have been employed as a treatment for cognitive and behavioral symptoms in dementia for decades, but the literature has lagged behind this practice. Eight reports on use of psychostimulants as a treatment of apathy in dementia were reviewed. Methylphenidate was the most frequently studied medication and improvements in apathy were consistently noted; however, the magnitude and duration of effect remain unclear. Six studies examining the cognitive effects of a variety of psychostimulants in patients with dementia were reviewed; psychostimulants had little to no effect on cognition. A lack of studies exists to draw conclusions about the use of psychostimulants for the treatment of excessive daytime sedation in dementia. The possibility of psychostimulants to increase blood pressure; elevate heart rate; and lead to irritability, agitation, and psychosis makes careful patient selection critical, especially in older adults with severe cardiovascular disease or other underlying cardiac abnormalities.

CONCLUSIONS:Based on limited studies, methylphenidate is a possible treatment for apathy in patients with dementia. Psychostimulants, as a group, do not appear to be broadly effective treatments for behavioral or cognitive symptoms of dementia. The potential utility of psychostimulants must be balanced with careful patient selection.



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To: freelyhovering who wrote (38385)6/5/2012 11:34:15 AM
From: DewDiligence_on_SI   of 40275
 
Provigil doesn’t impede the development of AD, but Nuvigil (the single-isomer formulation of Provigil) does.



























jk, of course :-)

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To: DewDiligence_on_SI who wrote (38387)6/5/2012 11:52:41 PM
From: freelyhovering   of 40275
 
Where did you find the info on Nuvigil and AD?

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To: freelyhovering who wrote (38388)6/6/2012 10:13:53 AM
From: DewDiligence_on_SI   of 40275
 
Did you read all of my previous post? :-)

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To: DewDiligence_on_SI who wrote (38389)6/6/2012 10:34:37 AM
From: freelyhovering   of 40275
 
I'm sorry that I have not. I remember you from years ago as a very serious financial guy so I was surprised by the comment. No great harm. I think that taking Nuvigil does help me and I was looking for some science to back up my experience as my mother just died from complications from Alzheimer's at 96.
Are you still on faculty at UT Southwestern? I am still Clinical faculty there.

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