Corey Wood was a week away from her graduation from the University of
California at Berkeley when she started getting flashes in one of her
eyes. Her doctor was concerned and had an inkling that something serious
was going on, so he took the unusual step of ordering a body scan.
Corey was a healthy 22 year old who was tremendously fit and who had
already completed eight marathons. Yet, stunningly, her tests revealed
that she had stage IV lung cancer. The flashing of light she was
experiencing was caused by a tumor behind her eye. But the disease was
also in her lungs where there were multiple tumors and the disease had
rapidly metastasized to her bones. Her prognosis wasn’t very good.
However, a sample of her tumor was sent to Foundation Medicine for
genomic analysis and it was found that her cancer was being driven by an
ROS-1 genetic alteration. Fortunately, a drug had been recently
approved to treat this very type of cancer – Pfizer’s Xalkori
(crizotinib). Xalkori is one of the new generation of drugs called
targeted therapies, drugs specifically designed to treat Corey’s ROS-1
driven cancer in a way that does not cause the concomitant horrific side
effects associated with traditional chemotherapy. After taking two
Xalkori pills a day for three months, all the while going about her
normal activities, Corey was cancer free.
Corey shared her inspirational story yesterday at the Forbes Healthcare Summit
held in New York City. The eradication of her disease shows the power
of the tools available to treat cancer that were thought of as science
fiction just a decade ago, such as whole body scanning, genomic analysis
of her tumor, and having a targeted drug available in the pharmacy to
eradicate her disease. This approach to treating cancer is only going to
get better. There are hundreds of targeted therapies in development in
the pipelines of dozens of biopharmaceutical companies. There
are other breakthroughs being made as well, particularly in the
exploding field of immuno-oncology where drugs such as Yervoy
(Bristol-Myers Squibb) and Keytruda (Merck) are helping to stimulate a
cancer patient’s immune system to fight the cancer. These are incredibly exciting times.
After Corey’s talk, Forbes’ Matt Herper led a panel discussion with
Peter Bach (Memorial Sloan Kettering Cancer Center), Bob Hugin (CEO, Celgene CELG +0.41%), Richard Klausner (CMO, Illumina ILMN -1.42%),
and Sandra Swain (Medical Director, Washington Cancer Institute). The
session tried to answer the question “Are we at a tipping point for
cancer and are we on the doorstep of vanquishing this disease?” This was
a great discussion about changing treatment paradigms, access to
healthcare, and emerging science. But Bach brought the group to the key
issue facing oncology – the costs of treatment. Yervoy and Keytruda are
great drugs, but they cost $120,000 and $150,000 per year, respectively.
Furthermore, these drugs are not going to be used as stand-alone
agents. Rather they will be used in combination with other drugs such as
targeted therapies.
The good news is in the not too distant future, a cancer diagnosis
will not be a death sentence. Rather, this will be a treatable condition
controlled by taking a combination of these breakthrough therapies.
However, people may require a combination of these therapies for the
rest of their lives. Imagine millions of people needing a cocktail of
three drugs, each of which costs $100,000/year/patient. It doesn’t take
major economic analyses to realize that the costs inflicted on the
healthcare system will not be sustainable in such a scenario
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