This is not financial advice. Do your own research. We all remember the FTO discovery, and most of us were too slow to really understand how big it was. I do not want to repeat the same mistake. Therefore, motivated by the most recent breakthrough discovery, I have attempted my own valuation of the FIC/BIC cardioprotective, synergistic (shall we call it SynGuard?) nature of Zantrene in combination with cardiotoxic anti-cancer drugs. All I can say is buckle up.
IntroductionThe cardiotoxicity associated with anthracyclines has been well documented and very adequately discussed on these forums. For those who may be new to RAC, cardiotoxicity is a very common side effect of a certain chemotherapies (types of cancer killing medications) - it's a bummer because while the drugs kill cancer quite well, the patient is back in a hospital bed 10 years later with heart failure. Keeping "todays cancer patient, tomorrows cardiac patient" front of mind helps. Now, the cardiotoxicity is so strongly associated with Anthracyclines that researchers have spent the last half century trying to find ways to reduce the cardiac side effects whilst maintaining the anti-cancer efficacy - basically, kill cancer without damaging the heart. On Monday the 22nd of November, 2021, RAC announced that they had found a molecule that not only protected the heart, it synergised with anthracyclines to kill the cancer better. Groundbreaking. Now, posters like myself,
@RaceOncology, and
@LongTony quickly brought these results into focus for you all providing some information about the clinical relevance as well as the financial opportunities. However, it is necessary to open the scope to truly understand how large an opportunity like this is. This work will contain my efforts at a valuation for Zantrene's SynGuard (sounds too much like a Marvel character for me LOL; let's call it
Zan+) in chemotherapeutic agents that have a similar cytotoxic effect on cardiac heart muscles as anthracyclines, namely tyrosine kinase inhibitors (TKIs), alkylating agents, monoclonal antibodies(MAb), and interferon alpha(INF-a), as well as cytarabine (an antimetabolite) which already has clinical data demonstrating Zantrene's synergy and cardioprotection.
Methods The number of patients per year was determined by expert opinion for anthracyclines, and by dividing the global drug market value of the nearest year by the average yearly cost of treatment for alkylating agents, TKIs, INF-a, MAb, and Antimetabolites. The number of treatments per year was determined by expert opinion for anthracyclines, and through research for other chemotherapies. Despite countless attempts, the true number of treatments per year that would be required for Zantrene is not known and may be above or below those quoted below. The cost of Zantrene used in this analysis was generated by assuming the same cost of the treatment Doxil minus the generic cost of Doxorubicin (USD $60), which totalled
USD $2940. Yearly revenue was calculated in Australian dollars by multiplying the number of patients by the number of treatments per patient and the cost of Zantrene, while dividing by 0.72 (the USD/AUD ratio at the time).
ResultsIf Zantrene is found to synergise with the six classes of drugs below while also providing cardioprotection, the estimated yearly revenue potential totals AUD $163.3B. However, given my knowledge of FTO, and the role it plays in some, but not all cancers, I suspect that there will only be a subset of patients that are eligible for Zan+, which may reduce the yearly revenue potential. Indeed, however, there may be more chemotherapies that cause damage to the heart and that synergise with an FTO inhibitor, increasing yearly revenue potential.
Discussion/SummaryIt is safe to say that I am absolutely astounded by this discovery. I genuinely feel like a mad man posting this onto the forum, but I have spent most of the week/weekend working on this and attempting to understand how big of discovery it is. The point that I find the most interesting is that Zantrene was found to synergise and be cardioprotective with high-dose Cytarabine in poor prognosis, heavily pretreated (mostly with anthracyclines) children. That market on its own is worth AUD $5B per year. We literally already have clinical data to draw conclusions from, which highlights how extremely advanced Zantrene is within this Cardioprotection/Synergistic space.
While I am conscious of the fact that some patients will be eligible for the Zan+, I also recognise research that has shown FTO is upregulated following treatment of anthracyclines. This does make me wonder whether FTO will become upregulated following the treatment of other chemotherapeutic agents, which may increase the number of patients eligible for this drug.
I believe the pricing of Zan+ to be conservative, which highlights how extremely high the valuation can get. For interest, when you move the price of Zan+ to USD $4940, the total yearly revenue is AUD $274B with the same number of patients and treatments per year.
I highly doubt that there is any conceivable chance that a pharma company is going to roll in and buy a drug for over $100B. This valuation is not intended to highlight a buyout price, rather to put into perspective the value of the discovery. It's enormous, and one or many pharma companies will likely see what I and many others see. Dollar signs, basically.
LimitationsI'm an idiot. If you want someone smarter than I, maybe you should head over to the IMU page; they seem to be rather confident that I know nothing. In all seriosness, I have limited access to data, and limited skills doing a valuation like this. Despite my efforts to be accurate, I recognise that the number of patients and number of treatments per year may be wrong by a large margin in either direction. I also understand that the price of Zantrene may be higher or lower than what I have suggested in my work. It is not yet known the number of chemotherapeutic agents that Zantrene could combine with providing added cardiac protection and efficacy, which would greatly alter the yearly revenue potential.
ConclusionsZan+ is a FIC/BIC opportunity just like the FTO discovery; the yearly revenue potential is astronomical. To my knowledge there are no other drugs within this class (the class is yet to be determined), therefore competition may be extremely high between competing pharmaceutical companies. Having a drug that can achieve FIC/BIC status in two completely novel areas is unheard of. I suspect that the cardioprotection is confered through some unknown MoA while the synergy is demonstrated through inhibition of FTO, which can only come down to immense luck.
As a side note, I wonder if other FTO inhibitors will see heart related side effects in the clinic (particularly when combined with other agents), as they do not have this cardiac protection MoA. Food for thought.
