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Dendreon: Pro-Provenge Activists Heap Abuse on Cancer Drug’s Critics

By Jim Edwards | Oct 7, 2008

It’s been a just a day since Dendreon announced that the interim analysis of its Provenge anti-prostate cancer candidate showed some — but not enough — improvement in sufferers, and already the drug’s army of web activists is heaping abuse on those who suggest that possibly, just possibly, this drug isn’t going to get approved by the FDA.

Dendreon said the drug lowered the death rate in its 500-person study by 20 percent — not bad, except that the FDA wanted to see a 22 percent reduction in order to end the study early and put the drug on the fast-track for approval. As it is, Dendreon must take the study to its full term, and those results won’t be due until 2009. Back story here.

In the meantime, three things have happened:

  1. The stock has gone up — so lots of people clearly think Dendreon is going to pull this one off.
  2. Analysts have sounded words of caution.
  3. The community of web activists who follow Provenge with religious zeal have taken to the bulletin boards to chastise anyone who dares ask questions about this drug.

Here’s what analysts said about the results:

Not as good as it could have been, nor as bad as it could have been. — Paul Latta of McAdams Wright Ragen.

We maintain our view that any meaningful survival advantage of Provenge treatment would become apparent only upon final analysis … We assume a 50-50 likelihood that the trial may demonstrate a survival benefit upon final analysis. –  Joel Sendek of Lazard Capital Markets.

Those seem like the reasonable, cautiously optimistic comments of people who know how hard it is to get a drug approved by the FDA, and that even very promising drugs turn out to have hidden trapdoors that can kill off their chances at the last minute.

But not to the pro-Provenge crowd. Unlike most other drugs, Provenge has taken on the aura of a cause for some. Those folks have taken to the net to pour boiling oil on anyone who dares criticize Provenge. Here’s what they’re saying in reaction to yesterday’s news:

APPROVE Provenge NOW and save 83 men per day from a horrible death!
DO THE RIGHT THING, APPROVE PROVENGE NOW!!!
May God Bless all those who fight to right this terrible wrong.

Matt Herper at Forbes dared to suggest that with only 500 patients in the trial, perhaps it was not large enough to provide the kind of statistical robustness that will pass muster at the FDA. Big mistake, Matt! Check out what people wrote on his comment boards:

your report was far from neutral. There appeared to be a deliberate effort to put a negative tone to the interim result.

Since such patients will likely die in a short period of time, treatment options, even if unproven, are often desired by such patients. This is understandable, because at such a severe stage of illness, such as prostate cancer, possible extension of their lives with comfort is worth it to them, regardless of lack of evidence of proof of whatever treatment that may be advantageous to them regarding these issues.

Mr. Herper: One can only conclude you are short DNDN, or represent the interests of those who would want to thwart a therapy that gives hope to prostate cancer sufferers - that would be the chemo establishment.

That’s nothing compared to the time a few months ago when Herper suggested that the interim analysis itself might not be all that useful. (Note, he turned out to be right.) Here’s what the Provengistas said then:

You need to start thinking what is best for the Men who are DYING instead of Manipulating the Market. What will you say about ALL the MEN that have DIED after this is approved?

Your article is much like your writing ability…..its garbage!

Some of them have even decided that Provenge works regardless of the evidence. Here’s what one person wrote after Joe Tartakoff of the Seattle PI suggested that Dendreon’s Q2 conference call was a non-news event:

ALL I CAN SAY 2 ANYBODY THAT BELIEVES THE IMPACT DATA TRAIL WILL FAIL IS U ARE A COMPLETE IDOT!!

(Spelling in the original.) And this is in a trial to which the company itself is blinded …

Jim Edwards, a former managing editor of Adweek, has covered drug marketing at Brandweek for four years, and is a former Knight-Bagehot fellow at Columbia University's business and journalism schools. Follow him on Twitter or send him an email.

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  •  
    1

    sstudy@...

    10/07/08 | Report as spam

    RE: Dendreon: Pro-Provenge Activists Heap Abuse on Cancer Drug???s Critics

    Here's the thing. My Dad died waiting for Provenge. Like others with this disease, it was heartbreaking for our family to sit there and watch an otherwise vibrant 65 year old man wither away and endure horrible suffering that ended in a painful death 8 months later. So yes, I get a bit emotional when I think of the fact that 1 in 5 men with terminal prostate cancer won't get more time with their families and will have to go through what we and many others have been through all because of 2%. 20% instead of 22%? For God Sake! We'd like to of had that chance for Dad.
    For us and many others this isn???t just an academic exercise. Real men with real families are dying while they wait. From here the decisions of the FDA look capricious and mean spirited. Here is a treatment that continues to show positive results with little to no discernable downsides as compared to the alternative standard treatments and yet we wait to hit just a little higher target.
    For our family it was too long a wait.
    Respectfully,
    Stephen Study
    Part of the ???pro-Provenge crowd???,
    Internet Zealot,
    and son missing his father

  •  
    2

    arke

    10/07/08 | Report as spam

    RE: Dendreon: Pro-Provenge Activists Heap Abuse on Cancer Drug???s Critics

    The final result has to show a 22% reduction in deaths. The interim showed a 20% reduction, closely matching previous trials. The final result of previous trials showed a 33% reduction in deaths, so it is unlikely that the trial will fail.

    The reason the FDA gave for denying approval before was that survival was not pre-specified as the goal of the earlier trials. Had it been, Provenge would already be on the market.

    The trial is testing Provenge treatment compared to the best treatment available, so the 'placebo' in this case is chemo. If the FDA was not under the influence of the big companies and oncologists that make huge profits on chemotherapy, they would certainly make a therapy that reduces death by 20% with essentially no side-effects available immediately.

    If the FDA withheld a treatment that saved 20% of patients dying of breast cancer, would people stand for it?

  •  
    3

    bull trout

    10/07/08 | Report as spam

    RE: Dendreon: Pro-Provenge Activists Heap Abuse on Cancer Drug???s Critics

    Heaped abuse? Hardly. Your inflammatory language
    seems out of place while writing an article decrying the
    militance of the "provenge crowd" (thanks for the
    gratuitous smear there).

    "Those folks have taken to the net to pour boiling oil
    on anyone who dares criticize Provenge."

    Financial "journalists" are not boy scouts and they all
    have their own agenda. I also have mine. Whether
    theirs is to try to discourage investors or just to sell
    newspapers, the tone of many, many articles about
    Provenge are decidedly negative. Matt's article was one
    such. An uninformed reader might say that attempts
    at balance were made, but to the initiated, the article
    was clearly negative in tone.

    While the drug showed a 20% survival benefit "there
    was a slim chance that it harmed patients" or was "not
    even as effective as the placebo". That was his focus,
    the 5% chance it was a fluke. But, this is the 3rd Phase
    3 trial that has demonstrated the same effect.

    Just because we don't accept Matt Herper's word as
    gospel doesn't make us a "crowd" (read mob). I hardly
    think he is as well educated about Provenge as he
    pretends. I am here just to so that people can read
    the other side of the argument.

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