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Trial & Error: The Changing Landscape Of Cancer

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Cancer is the second leading cause of death in the world, next to heart disease. There are more than 200 types of cancers, and based on their tissue types, they are grouped into 5 main categories namely carcinomas, lymphomas, leukemia, brain tumors, and sarcomas. In the U.S., the most commonly diagnosed cancer is Skin cancer, and the leading cause of cancer deaths is Lung cancer.

The first cancer drug to win the FDA nod was Nitrogen mustard, a chemotherapy agent, in the year 1949. Over the years, there have been some significant advances in cancer treatments as well as in cancer diagnosis. A recent report on cancer rates and trends published by the American Cancer Society has some good news.

According to the report, the overall cancer death rate in the United States from 1991 to 2016 has declined 27%, translating to approximately 2.6 million fewer cancer deaths. Some of the other interesting observations are a 48% decline in mortality rate among men in lung cancer and 23% drop among women; 40% decline in breast cancer death rate; 51% drop in prostate cancer death rate and a 53% decline in colorectal cancer mortality.

However, death rates from cancers of the liver, pancreas, brain, and sites within the oral cavity and pharynx associated with the human papillomavirus (HPV) are on the rise.

The total annual cost of cancer care in the United States (including direct and indirect costs) is estimated at over $96 billion. (Source: NCBI).

Most cancer drugs launched between 2009 and 2014 were priced at more than $100,000 per patient for one year of treatment while some of the recently launched drugs cost more than $400,000 for a year of treatment. (Source: NIH). For example, Novartis' Kymriah, launched in May 2017, costs $475,000 (list price) while Gilead's Yescarta, launched in October 2017, is priced at $373,000.

With premium pricing and increasing demand, many of the cancer drugs have achieved blockbuster status. Based on 2017 performance, the top-selling cancer drug is Celgene's Revlimid, and it raked in U.S. sales of $8.19 billion.

Among 21 major disease indications, cancer drugs are said to have the lowest success rate of making it from phase I clinical trials to FDA approval, say only 5%. (Source: Bioresearch).

Let's take a look at some of the companies whose cancer drugs are in phase III /pivotal trials.

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