Pretty impressive when you consider that this is cut by 50%.
I have taken the time to go through all of the synergies that have been determined so far for Bisantrene both in vitro and in vivo. Here is are some of the therapies:
1. Everolimus: An mTOR inhibitor that impedes cancer cell growth by disrupting the mTOR signaling pathway.
2. Sorafenib: A multi-kinase inhibitor targeting tumor cell proliferation and angiogenesis, used in hepatocellular and renal cell carcinoma.
3. Sunitinib: A tyrosine kinase inhibitor that blocks multiple receptors involved in tumor growth and angiogenesis, commonly used in renal cell carcinoma.
4. Pazopanib: A tyrosine kinase inhibitor that targets angiogenesis-related receptors, used primarily in renal cell carcinoma and soft tissue sarcoma.
5. Lenvatinib: A multi-kinase inhibitor that suppresses tumor growth by targeting vascular endothelial growth factor receptors, used in thyroid and renal cancers.
6. Cabozantinib: A tyrosine kinase inhibitor that targets MET, VEGFR, and other receptors to inhibit tumor growth and angiogenesis, utilized in medullary thyroid cancer and renal cell carcinoma.
7. Cobimetinib: A MEK inhibitor that blocks the MAPK/ERK pathway, used in combination therapies for melanoma.
8. Binimetinib: A selective MEK inhibitor targeting the MAPK/ERK pathway, used in combination with other agents for melanoma treatment.
9. Vemurafenib: A BRAF inhibitor that targets the BRAF V600E mutation, used in treating melanoma with this specific mutation.
10. Immunotherapy: A class of treatments that enhance the body's immune system to recognize and destroy cancer cells, used across various cancer types.
11. Carfilzomib: A proteasome inhibitor that induces apoptosis in cancer cells by disrupting protein degradation, primarily used in multiple myeloma.
12. Venetoclax: A BCL-2 inhibitor that promotes apoptosis in cancer cells by inhibiting a protein that prevents cell death, used mainly in chronic lymphocytic leukemia.
13. Decitabine: A hypomethylating agent that interferes with DNA methylation, reactivating silenced genes and used in myelodysplastic syndromes and acute myeloid leukemia.
14. Doxorubicin: An anthracycline antibiotic that intercalates DNA and inhibits topoisomerase II, widely used in various chemotherapy regimens.
There are more than this, but this is enough to illustrate the magnitude of what I believe RAC is aiming to achieve. I have thoroughly researched each drug listed and generated a market capture example for Bisantrene at a 50% penetration rate. To determine the value for market capture for each opportunity, I began by analyzing current US sales data, monthly costs, and the number of prescriptions per year for each drug. This allowed me to estimate the total addressable market and potential revenue at various penetration rates, such as 50% penetration or the number of cancer indications approved for immunotherapy or CPACS. I also included some of the leading drugs in each class where Bisantrene has not yet demonstrated an effect but would be a valuable addition. Where relevant, I factored in the buyout price at different stages and used these figures to calculate peak revenues and project share prices at different buyout multiples (AUD peak sales x3 or x5). This analysis enabled me to evaluate the financial opportunities across various therapeutic areas, particularly within CPACS, targeted therapies, and immunotherapies, identifying significant revenue growth potential with increased market penetration.
As you can see from the table above, each of these opportunities represents an excellent prospect for a biotechnology company to pursue. I believe that RAC is likely to initiate the Phase 1a/b CPACS trial to establish the world's first proof of concept, and then potentially move into these other areas, likely through investigator-led Phase 2 trials. This approach seems to be the most effective way to drive a competitive buyout. If the Phase 2 umbrella CPACS trial generates sufficient data for accelerated approval, the evidence suggests that achieving 5x peak revenues is possible. The more data we accumulate, the larger the potential figures become. When you aggregate the data from the table, it reveals some truly enormous numbers.
While I don't necessarily endorse these numbers or suggest that they will be achieved, my approach when evaluating biotechnology companies is to assess clinical and commercial risk relative to market size. Whether we like it or not, Bisantrene has already passed the approval process, indicating that it is both efficacious and safe. Remarkably, Bisantrene gained approval even before researchers and regulators fully understood its mechanisms of action—knowledge that we now possess. This significantly reduces its clinical risk, and its potential total addressable market (TAM) is enormous. The fact that I can derive these values using only US data underscores the magnitude of the opportunity. Bisantrene's TAM is challenging to quantify because there has never been a drug with its capabilities. As the first potent FTO inhibitor and a first-generation CPACS, Bisantrene could hold many untapped potentials. If historical literature is any indication, we might soon learn more about its effects on macrophage polarization and a1/a2 adrenoceptor inhibition. We haven't seen a novel platform drug like this since Keytruda, and perhaps it’s time for another breakthrough!
I would be interested to know others thoughts on the market size for Bisantrene.
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