The dread and fear that can come with a cancer diagnosis have their roots in its killer nature. It is the number two cause of death in Americans, second only to heart disease, according to the Centers for Disease Control and Prevention. Even when diagnosed early and attacked with the latest treatments, it still has the power to kill. We reported earlier in the week on the advances being made in the search for a cancer vaccine. Two companies, Amgen Inc. (NASDAQ: AMGN) and GlaxoSmithKLine (NYSE: GSK), have made significant strides and have highly anticipated clinical data due out this year.

The cancer research team at Bank of America Merrill Lynch did an in-depth survey on hematology and oncology drugs. Today they published results from a survey of 74 hematology/oncology community practices conducted in early January to gauge the latest adoption trends for key biotech drugs in the myeloma landscape. They focused on five companies with drugs for treatment of this form of cancer.

Alexion Pharmaceuticals Inc. (NASDAQ: ALXN). Their survey found a strong uptick for Soliris in the fourth quarter of 2012 and projects continued aHus gains in 2013. The biggest gating factor to using Soliris in aHUS is diagnosis. Atypical hemolytic uremic syndrome, or aHus, is a rare, life threatening genetic disease.

Ariad Pharmaceuticals Inc. (NASDAQ: ARIA). Iclusig use is expected to be driven preferentially in Sprycel/Tasigna failures, with physicians in 2013 preferring Sprycel/Tasigna in Gleevec failures. Physicians appear to view Sprycel and Tasigna as comparable drugs, Iclusig/Bosulif will quickly gain share over Sprycel/Tasigna in 3rd line. Iclusig is preferred over Bosulif, but not dramatically (1.5x), showing Ariad has work to do to educate physicians on Iclusig’s differentiated profile.

Onyx Pharmaceuticals Inc. (NASDAQ: ONXX). The overwhelming current Kyprolis use is on label for dose and schedule; Kyprolis users are aware of drug induced dyspnea but plan to expand use cautiously. Negative trends but consistent with the model include: (1) lower
expected new starts in the first quarter of 2013 vs. the fourth quarter of 2012, driven by expected mid-Feb Pomalyst launch, and (2) weekly Velcade continues to gain share, placing increasing importance on Onyx recently started weekly dosing study. Positive trends include: (1) increased Kyprolis/dex combo use (now 30%) and (2) use in earlier lines of therapies (25% one or two prior therapies) suggests a positive sales impact from increasing treatment duration over time.

Celgene Corp. (NASDAQ: CELG). Pomalyst launched in the first six months is predicted to be comparable to Kyprolis, ahead of consensus but in line with their model. Some 50% of Pomalyst use is expected post Kyprolis, 35% before Kyprolis and 15% in combination.

Incyte Corp. (NASDAQ: INCY). The survey found heterogeneous responses to Jakafi’s overall survival data presented for the first time in December, and their overall conclusion is that more data/education are needed to solidify consensus. Still, responses imply a gradual demand uptick. Of the two-thirds of physicians who believe there is a convincing survival benefit, 70% expect these data to modestly increase their Jakafi use in 2013 from 2012.

While much of the survey data is tedious, the treatments for multiple myeloma are expanding. Multiple myeloma is the second most common hematological malignancy after non-Hodgkins lymphoma.

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