Cougar Biotechnology (CGRB) is a publicly traded company focused on developing novel treatments for cancer. The company is developing CB7630 (Abiraterone Acetate), a small molecule for the treatment of hormone refractory prostate cancer [HRPC], and has completed several clinical trials demonstrating its efficacy. The National Cancer Center reports that there are over 186,000 new cases of prostate cancer a year. Of these, 20 percent will be diagnosed as metastatic and will become hormone refractory.

So let's put this into some tangible numbers. This means that the market for HRPC encompasses 37,200 patients per year. Assuming pricing inline with most cancer biologics, ~$40,000 a year, and using a basic model of risk adjusted net present value we hit $825 million, for a $40 dollar value per share. Not too shabby.

As of writing this analysis, Merck (MRK) announced the results of its ENHANCE trial pitting their statin/ezetimibe combination drug Vytorin against statin alone in a patient population heterozygous for familial hypercholesterolaemia. Both treatments decreased serum LDL levels by 40-58 percent. Most people were surprised by the fact that the greater reduction in LDL by Vytorin did not result in a more pronounced decrease in carotid artery thickness. It should be noted that this population, even with the decrease in LDL, would still be considered at the top of the risk category. It should also be noted that the change in carotid thickness is statistically insignificant, a far cry from the “twice as bad” that the media is purporting.

An interesting editorial in the New York Times brings up the idea that we may be interpreting metabolic biomarkers incorrectly. Drug discovery can be so precise as to hone in on a certain indicator of disease and manipulate its levels. Recent research has begun to uncover that LDL-ladden ApoB is a better indicator of cardiovascular heart disease than pure LDL levels, which shines some light on the Isis-Genzyme 1.9 billion dollar deal, where Isis’ drug mipomersen decreases LDL-C by 70 percent with concomitant decreases in ApoB.