ASA404 approach in treating lung cancer

Implications: ASA404 begins pivotal trial to explore new approach in treating lung cancer ASA404 is a drug that helps chemo treat lung cancer yet eliminate exisiting blood vessels supplying the tumors

Analysis:   As we have seen in the past, don't get too excited about phase II data. The results are often, at best, half as good when studied in a randomized fashion. I am somewhat skeptical of a drug that does not help the potential delivery of chemo to the tumor. Avastin has improved the response to chemotherapy in NSCLCa. It was later hypothesized that the Avastin increased chemo delivery before it actually decresed new vessel formation. The ASA404 does not have the potential to do this based on it's proposed mechanism of action and therefore it may not help, but actually impair chemo delivery. I feel we need to spend more time looking at preclinical models that can predict response to expensive endeavors as opposed to ignoring the proposed mechanisms and pursuing the project. While this approach of "treating first and figuring out the mechanism later" paid off for Avastin, it may be the wrong approach. I feel certain projects such as the attempt to look at the C-Met pathway to predict response in various tumors prior to embarking on clinical trial is the best way to see a lot of money go to good use, in an area where big bucks are spent, only to have negative trials .