The company's Avastin (bevacizumab) is a monoclonal antibody raised against vascular endothelial growth factor (VEGF), one of the primary mediators of blood vessel growth (angiogenesis). It has been approved by the US Food and Drug Administration for use alongside the chemotherapeutic drug 5-fluorouracil in patients with advanced colorectal cancer, and will be sold in the US by Genentech.
The concept of treating cancer by blocking angiogenesis was first put forward in the 1970s by Judah Folkman, then a professor of surgery at the Boston Children's Hospital in the US.
Since then, dozens of compounds designed to treat cancer by blocking angiogenesis have entered into development and failed, including endostatin and angiostatin, which were originally discovered by Folkman and abandoned by licensee company EntreMed in 2002.
First-in-class products often have a premium price tag to match, and Avastin is no exception. Genentech has said that it will charge $4,400 (€3,530) a month for the drug which, given an average treatment time of 10 months, gives an average annual treatment cost of $44,000, markedly higher than the $25,000 expected by analyst Denise Gugerli-Etter of Sarasin.
With this pricing, she now expects Avastin to achieve sales of around SF 2 billion (€1.26bn) in 2007, while Roche chief executive Franz Humer has predicted peak sales of $2 billion in colorectal cancer alone.
Roche and Genentech are presently investigating the potential clinical benefit of the use of Avastin in a number of other forms of cancer, including non-small cell lung cancer, pancreatic, breast and renal cell carcinoma. Large clinical trials are also underway in patients with colorectal cancer that has not spread (adjuvant therapy).
Analysts at Lehman Brothers have predicted that, with approvals in other indications beside colorectal cancer, peak sales of Avastin could eventually reach $3.5 billion.
In 2000, colorectal cancer was the third most commonly reported cancer with 945,000 new cases worldwide. It is estimated that over 50 per cent of people diagnosed with colorectal cancer will die of the disease, and it is the most common cancer in developed countries.