Citing the way Los Angeles Lakers teammate Magic Johnson brought awareness to HIV, Abdul-Jabbar said he wants to do the same for his form of blood cancer, which can be fatal if left untreated.

"I've never been a person to share my private life. But I can help save lives," he said at a midtown Manhattan conference room. "It's incumbent on someone like me to talk about this."

Abdul-Jabbar became concerned last year after feeling odd sensations. He went for tests at UCLA, where he dominated college basketball in the late 1960s, winning three straight NCAA championships from 1967-69.

"I was getting hot flashes and sweats on a regular basis," he said. "That's not normal, even for my age."

An exam showed his white blood cell count was "sky high" and a doctor quickly diagnosed his condition. At first, all Abdul-Jabbar heard was the word "leukemia."

"I was scared," he said. "I thought it was all the same. I thought it could mean I have a month to live."

"That was my first question," he said. "Was I going to make it?"

Wow, that was one of the first things that caught my eye this morning on Twitter - a tweet from ESPN that Kareem Abdul-Jabber had a rare form of leukemia.

Turns out he has chronic myeloid leukemia or CML and you can hear about his story in this video (source: ESPN)

The article goes on to say:

"The six-time NBA MVP intends to post updates to his Facebook and Twitter accounts and stay connected through www.CMLearth.com, a Web site for those afflicted by the disease."

It's good to see him actively promoting awareness of the disease, much in the same way his old Lakers colleague Magic Johnson did for HIV related issues.

Disclosure: I'm a former employee of Novartis and marketing director of Gleevec, one of the three kinase drugs approved for the treatment of the disease, so naturally I'm a little biased as it was a truly wonderful experience to launch something that really made a difference to cancer patients lives. Mr Abdul-Jabber is a private person and therefore is discussing his disease in general, rather than which treatment regimen he is specifically following.

Posted via web from sally church's posterous

A few weeks ago, the LA Times reported that 15 states are suing Amgen over accusations of offering kickbacks to doctors to prescribe Aranesp. The states accuse Amgen sales representatives of encouraging doctors to bill insurers for Aranesp that the practitioners received free from the company.

What is clear to all of us is an industry-wide failure of compliance programs and lack of ethical integrity by pharmaceutical marketers and sales professionals.  In its own way it is a sad reflection of the greed that gave rise to the excesses of Wall Street.   It is likely that more settlements will be announced, although one can naively hope not. 

Despite the 40,000 layoffs reported in the Pharma industry this year, there are going to be plenty of jobs for experienced compliance professionals as pharmaceutical companies attempt to put their houses in order.

Bearing in mind that many of the readers of this blog or people I interact with on Twitter and Friendfeed are from the Pharma and Biotech  or healthcare industries, I thought it would be fun to test the Hunch tool out here and crowdsource some information about our little sector.

The answers are totally anonymous and aggregated.

Here's the survey, just click the Hunch link to get started:

When you have finished, please let others know and spread the word! The more people we have doing the survey, the more robust the answers will be. I'll post an update of the aggregated results at the end of the week.

As the conversation continued, we discussed the value of continuous learning and how we get smarter by reading great blogs from other people.  Then I got floored with a neat question; "which blogs do you actually read every day and enjoy?"

This brings me to the topic of this weeks Friday afternoon fun - putting other people in spotlight.

Although I aggregate a lot of feeds, I don't actually read them all and instead use them for search purposes.  On my Mac Mail, however, is a nifty feature that allows me to import RSS feeds of blogs I enjoy reading daily, like this:

As new blogs are posted, a number to the right indicates how many are unread.  This makes it easier to track new posts.

I also use the Notes feature above the RSS to jot quick thoughts and ideas to myself around things I find interesting.  These are synced with my iPhone and important topics I also email to my Evernote database partly as a backup and partly because I also use its awesome search features in conjunction with the RSS search.

So, what do I read daily?  An eclectic mix from science, medicine, tech, finance, economics, food and of course, pharma and biotech.  This list is continually refined with new ones added and old ones deleted.  For me, though, they're interesting and thoughtful people and I learn a lot from smarter people who take the time to think and write about a wide range of things.

Check them out, you may find some new ones you like too.

Posted via email from sally church's posterous

It has previously been shown that CRC patients with mutated KRAS do not respond to EGFR kinase inhibitors whereas those with wild type mutations do, so one would expect the selected patients to do well and chances of success are increased.  However, although the Vectibix arm did better, the result was not significant:

"The prospective analysis of the 203 study showed that Vectibix, when added to a FOLFOX chemotherapy regimen in patients with KRAS wild-type mCRC, resulted in a median overall survival of 23.9 months compared to 19.7 months for patients treated with FOLFOX alone. The median overall survival difference of 4.2 months in the Vectibix arm did not reach statistical significance (HR=0.83, p=0.072)."

Interestingly, according to the newswires some analysts appear to be claiming that regulatory approval and successful sales growth was still possible:

"We believe the positive trend coupled with a robust [progression free survival] benefit will be adequate to support regulatory approval," J.P. Morgan analyst Geoffrey Meacham wrote in a note to clients.

He said that "modest" use of Vectibix in new patients, and an increase in patients who failed previous treatment, could boost his 2012 sales view of $445 million by about $300 million.

Neither Vectibix, nor Erbitux, another EGFR inhibitor from ImClone, are approved for the treatment of newly diagnosed colorectal cancer.

We'll see what the regulatory authorities have to say about the Amgen data.  Strategically, however, given that most medical oncologists look at OS as the gold standard that was not met in the patient population most likely to respond, I think it will be hard for Vectibix to gain any real traction in the first-line setting for this disease against Genentech's Avastin even if it is approved, especially when you factor in a more costly therapy and a very nasty rash as a potential side effect. 

My own view is that the negative OS result is likely to be more of a death knell in newly diagnosed colorectal cancer for Amgen, but time will tell.

Watch this space!

It's no wonder that with thousands attending these meetings, people (health care professionals and consultants alike!) become overwhelmed by the sheer volume of data and information available.

One of the things I really enjoy though, is the smaller, more intimate meetings either focused on the local needs or around a more specific topic such as an individual cancer (World Lung Congress, Miami Breast Cancer meeting and the International Society for Gastrointestinal Oncology); all are excellent meetings for getting a snapshot around more specialist areas, for example.

However, my favourite little conference outside of ASH, ASCO and AACR is the New York Chemotherapy Foundation Symposium held annually in November at the Marriott Marquis in Times Square.  For those interested, it was started by Dr Ezra Greenspan:

"Dr. Greenspan was the pioneering oncologist who founded The Chemotherapy Foundation in 1968 and the Chemotherapy Foundation Symposium in 1972 in order to bring the new developments in cancer therapeutics to practicing oncologists in the years ahead. His goal was the control and eventual cure of cancer."

Image by Michael McDonough via Flickr

From my perspective, the meeting offers lots of little snapshots and vignettes on the cutting edge data that will impact community medical oncology either now or in the near future.  They invite a lot of the experts running the trials from around the country, so you get a great sense of what's happening in areas you may be less familiar with as the program shows.  In the past, some of the keynote speeches have also been great fun and quite irreverent, which also means you tend to remember the important data better.

The Greenspan meeting is being held at Times Square in NY next week, so I'll be live tweeting key snippets from the event from Tues to Friday under the hashtag #NYCT. 

If anyone is either at the meeting or in NY and wants to meetup for coffee, lunch or dinner for some social networking, do let me know.  You can tweet me @maverickNY and I'll be sure to return your shout out.

Sometimes taking time out from the hurly burly of meetings and just stopping to think of absolutely nothing can allow those deep thoughts and ideas to bubble up more freely.  Insights from customers, patients and consumers can help us understand both the market and the needs for a product, but only if we stop and reflect on things as a whole rather than looking at individual pieces in isolation.  Otherwise analysis paralysis will ensue or wrong conclusions made based on incomplete data.

Source: H. Koppdelaney via Flickr

A client recently asked me how we create big picture ideas from nothing and come up with strategic trends in the disease landscape. 

The answer isn't a simple one, but often, with the volume of reading we do every day across a huge variety of topics things get hidden deep down in memory and may not be immediately obvious at first. This is also true if you want to mine a database for information, you have to know what you are looking for to start with in order to see the wood from the trees. 

For me, I find my best ideas and heightened levels of awareness come from being back to nature while out walking and thinking about absolutely nothing.  Once you have some ideas, you can test them based on the data available and see if relevant trends emerge. This also applies to other related areas such as market surveillance and market research - it's all very well having a big pile of interview transcripts, but you still have to put the story back together in a logical, coherent way that makes sense.

Sometimes, other peripheral things can also trigger new ideas in your consciousness too.  This process can take place over several weeks as a picture emerges from the chaotic jumble, rather like a child puts a painstakingly puts a jigsaw together.  Out of emptiness comes greater awareness, perception and fresh ideas.

How do you put yourself in touch with your own consciousness and awareness?  Do you generate insights differently?

"The other travelers came walking down the track
And they never went further, no, they never went back
Then came the churches then came the schools
Then came the lawyers then came the rules"

Dire Straits, Telegraph Road

As a European in the USA over the last ten years it never ceases to amaze me how expensive everything is in healthcare compared to back home.  That goes for dentistry too, but that's a whole 'nother story.

What is both interesting and tragically sad is comparing the US with other countries in terms of various healthcare costs and finding it number one in just about every category, it isn't just the drug companies charging higher prices, physician fees, hospital costs etc are also much higher than in other Western nations including Canada and European countries.

The Montclair State University Sociology Dept compared the costs of:

• an office visit
• a day in the hospital
• a common procedure (childbirth without complications)
• a widely used drug (Lipitor)

And found the USA stood out every single time:

They downloaded the data, and plenty other examples, from here (warning PDF file).

Strategically, the data makes you realise that healthcare reform is more than just reducing drug costs and blaming the Pharma and Biotechnology industry, because the hospitals and doctors are also charging premium prices too. The whole economic system is completely out of whack and with the constant upward pressure on wages and costs over the last 10 years, everyone wants a piece of the pie.

The sad thing is that the ones left holding the baby are the patients, because they sure don't get 4 times the value of their European or Canadian counterparts.  When you couple the data above with data on the number of uninsured people as noted by the Health Populi blog:

"Between 2007 and 2008, 18% of American women between 18 and 64 years of age were uninsured. 1 in 10 women in this age group were enrolled in Medicaid."

"In 14 states, at least 1 in 5 women was uninsured."

You can see more key information in the statistics provided in the table below:

The end result is often tragic stories, where people lose their job, their ability to pay for insurance and risk dropping into a very big hole of debt or worse, they sadly die.  What kind of decent civilised system can even allow such stories to be imagined, let alone happen? 

As the recession bites deeper and more redundancies and layoffs occur, so the situation may well get worse before it gets better.  These sort of stories can happen to anyone who has the misfortune to lose a job and get sick.

There has to be a better way and fairer to provide more affordable healthcare for all Americans, otherwise bankruptcy on an unimaginable scale will surely ensue.  The European and Canadian systems aren't perfect since they may offer more limited choices, but they do offer healthcare for all and everyone has the right to be treated. 

In America, you're on your own and no one really cares unless they get paid.  Money talks.

I rarely write about politics on this blog but it goes without saying that I will NOT be voting for Chris Christie for NJ Governor today; his idea of making people pay even more for healthcare such as the cost of mammograms for the early detection of breast cancer was just a ludicrous bridge too far.  Where are the fresh ideas and inspiration for getting small, medium and large companies back on track in this State? 

Image by Getty Images via Daylife

As I look around me, it is 3 old school candidates with boring old school ideas that don't work anymore; patronage reigns supreme here, do your time, look after your own.  Who really cares about the We The People of the United States or even New Jersey?  In a few years, we might get some bright young things with fresh ideas and energy like Newark's Cory Booker or hey, Mayor Bloomberg, if NYC doesn't want you come over the Hudson and shake things up here!  NJ desperately needs shaking up and the corruption cleaned out once and for all.

To paraphrase Britain's The Sun newspaper: 

Will the last person leaving New Jersey please turn out the light.

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You’d see patients where interferon wasn’t working, and they’d been issued a death sentence. Suddenly, all their hopes for the future were restored, and, with minimal side effects! This was around 1999, and the Internet chat rooms were just beginning. Patients in the trials began talking to each other like they’d never done before. I’d see a patient, and I’d read about it on the Internet that night: “few side effects,” “100 percent response.” Patients would come to me and say, “My doctor has never heard of this drug.” I’d never written it up. I hadn’t presented the data. Their doctors thought I was a charlatan. For a lot of people, Gleevec was simply too good to be true. But these once-dying patients were getting out of bed, dancing, going hiking, doing yoga. The drug was amazing.

This is what we all live for in research, in medicine, in Pharma and Biotech... the chance to be part of something really exciting that makes a difference to patients lives and changes things like how we approach the treatment of cancer forever.

This was also true for the investigators such as Brian Druker, Charles Sawyers, Moshe Talpaz and John Goldman, all wonderful doctors who were proud to be part of something that truly helped their patients. It was truly a honour to work with them.

The side effects Brian describes above are were so very real as I went round the trial centres meeting the doctors and patients one long month back in 1999. There was a lot of very sick people in those clinics, many with advanced disease, maybe a year to live and others who had already booked their funeral but were hoping to live long enough for a particular family event like a a wedding or a child's peewee game. As the patients told their life stories, you could not be unaffected by their pain and desperate hope to live.  Some of those stories came from young people in their 30's, their life should be ahead of them and instead they were facing a death sentence.

The fledgling internet chat rooms in those days were wonderful sources of information and inspiration; imagine you can live the road well travelled with the patients in real time and see how they are doing, how they are responding etc.  Those quotes make for great stories to share when you hit roadbloacks in the drug development and somehow, everyone else involved on the process becomes inspired by those stories too.  Suddenly, problems become challenges to overcome and resolve.

It makes me sad to see Pharma marketers or review teams nervous of monitoring for fear of adverse events.  Embrace them, do something about them, learn from them, help them.  But most of all, travel the road with the patients and engage where you can.  They're your biggest fans and harshest critics. 

If you listen to their messages (as I did almost daily for 4 years) you can try and do things for the greater good of all patients with a disease and hey, you will be a much happier and humbler person / team / company for it.  People forget that we're here to serve, not to sell.  Between stimulus and response there lies a gap - you can choose your response and make a difference or not.  Indifference and apathy don't really sit well here.

Posted via web from sally church's posterous with additional commentary

One thing that jumps out that may well impact things for many people, including the probably rather relieved insurers, came from results eagerly anticipated after the recent data presented at the World Lung Congress was not yet fully mature.

There was an excellent post from Dr Pennell on the GRACE cancer website, which is one of my favourite cancer sites with commentary from practising physicians and a community debate where you can ask questions.  Great concept.  It's a non-profit venture established by the dynamic Dr Jack West and well worth supporting if you have an interest in cancer. 

The post refers to a really interesting snippet of news that has much relevance in the treatment lung cancer:

"On October 15th there was a press release that, as far as I can tell, went almost entirely unnoticed. News outlets reported that Roche (owner of Genentech, the maker of Avastin (bevacizumab)) reported to OSI Pharmaceuticals (the maker of Tarceva (erlotinib)) the final overall survival results from the ATLAS trial."

What's even more interesting is that neither Roche/Genentech or OSI Pharma have made an official announcement about the supposed results on their sites so far (as of 11/2), which according to CNBC was not positive for the combination.  It's unclear whether this is truth or rumour from the CNBC snippet but Dr Pennell did say that he had confirmed it with an OSI contact.  In some ways, if true, this is not really a surprise as there was much debate about early versus late maintenance therapy with several drugs at the recent ASCO meeting, previously discussed on this blog here and the ATLAS trial design here.

Dr Nasser Hanna was quite scathing in his ASCO discussion of the lung cancer oral session about early vs. delayed TKI therapy, arguing that waiting 3 months or so probably gave patients the chance to recover from first line chemotherapy, among other things.

Dr Pennell sensibly concluded that:

"My guess is that this should be enough to say that the combination of Tarceva and Avastin probably won’t achieve regulatory approval in the maintenance setting."

I'm inclined to agree with him, but we'll have to wait and see.

Unfortunately, it now seems that the final survival data was indifferent at best and AstraZeneca announced the sudden withdrawal of the marketing applications to the regulatory authorities this morning:

"The decision to withdraw these submissions was based on an updated analysis that demonstrated no overall survival advantage when vandetanib was added to chemotherapy as well as preliminary feedback from regulatory agencies that the current package with progression-free survival (PFS) as the primary endpoint may not be sufficient for approval."

Granted that oncology is a difficult area to develop new drugs, but the woes in this category have made for a sad and sorry 2009 for R&D this year so far.

With 2 months to go, perhaps we might see a stunning winner yet...