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Order a reprint of this article now  DECEMBER 8, 2009, 3:17 P.M.
ET.Novartis's Tasigna Beats Gleevec in Trial .ArticleComments (1)more
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By JEANNE WHALEN

Novartis AG's new leukemia drug, Tasigna, performed better than the
company's blockbuster Gleevec leukemia treatment in initial results of
a clinical trial, a finding that could help Novartis start positioning
the newer drug to replace Gleevec.

Gleevec is the company's second biggest selling drug, with revenue of
$3.7 billion last year. But it will lose patent protection and face
competition from low-cost generic copies in 2015. If enough doctors
decide that Tasigna is the better treatment, Novartis could hold onto
leukemia-drug sales longer because Tasigna's patent won't expire till
later.

The Novartis-financed study tested Tasigna against Gleevec in 846
patients who were newly diagnosed with a form of blood cancer called
chronic myeloid leukemia. After a year of treatment, a blood test
measuring the presence of the disease showed a major drop in about
twice as many of the patients who took Tasigna, according to results
of the study presented Tuesday at the American Society of Hematology's
annual meeting in New Orleans.

In about 80% of patients taking Tasigna and 65% of those taking
Gleevec, a chromosome indicating the presence of the disease
disappeared from the bone marrow. And more patients who took Gleevec—
about 4% compared with less than 1%—progressed to an advanced stage of
the disease.

Gleevec is known by the generic name imatinib. Tasigna's generic name
is nilotinib.

"The superior efficacy and favorable tolerability profile of nilotinib
compared with imatinib suggests that nilotinib may become the standard
of care in newly diagnosed CML patients," the doctors who led the
study wrote in an abstract summarizing the results. The study is set
to continue for several more years.

Gleevec has been on the market since 2001 and is considered one of the
great successes of modern cancer treatment. One study showed that
about 89% of patients taking the drug were still alive after five
years, a remarkable result for cancer treatment. There is little data
yet on whether Tasigna actually extends patients' survival, which is
the most important outcome of any treatment.

Novartis tried to design Tasigna to attack CML even more precisely
than Gleevec does. Both drugs work by binding to a pocket in an
aberrant enzyme called BCR-ABL that causes white blood cells to grow
and divide uncontrollably. Tasigna was designed to occupy that pocket
more snugly and shut down the enzyme's activity more fully.

Tasigna is already approved for sale in many markets for the treatment
of CML patients who are resistant to or intolerant of Gleevec.
Novartis said it now plans to ask regulators for permission to sell
Tasigna for use in newly diagnosed CML patients.

Eric Feldman, a hematologist at New York Presbyterian Hospital who was
not involved in the new study, called the data "pretty compelling" and
said Tasigna should be "seriously considered" as a treatment for newly
diagnosed patients.

Richard Stone, a hematologist at Dana-Farber Cancer Center in Boston,
called the data "encouraging" but said he might want to see another
year or more of data before prescribing Tasigna instead of Gleevec to
new patients.

Andrew Weiss, a pharmaceutical analyst at Bank Vontobel AG in Zurich,
said that because there is so much evidence that Gleevec extends
survival—while there is little yet for Tasigna— some doctors might be
hesitant to switch to the newer drug. Tasigna "needs to show that it's
even better than Gleevec in survival terms," he said. "Do we see that
with this data? No. Does the drug have the potential to show that
data? Yes."

Also, when generic copies of Gleevec become available, they will be
much cheaper than the still-patented Tasigna, which can cost more than
$40,000 a year. This could give some healthcare payers pause about
paying for Tasigna, Mr. Weiss said.

Write to Jeanne Whalen at [email protected]

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