$EXEL Share Price Jan 6 2014The share price of Exelixis ($EXEL) is starting a run-up (after months in the doldrums) in advance of anticipated results from the COMET-1 phase 3 trial in metastatic castrate resistant prostate cancer (mCRPC) for cabozantinib (Cometriq, formerly XL184).

Cabozantinib is a small molecule tyrosine kinase inhibitor of c-Met and VEGFR2. It has been shown to significantly improve bone scans and decrease pain, but the $64,000 questions are will patients taking it live longer and feel better?

The answers will come from the COMET-1 trial that has a primary end point of overall survival (OS). It’s a placebo-controlled trial of 960 men with advanced prostate cancer randomly assigned to cabozantinib 60mg (n=640) or prednisone (5mg twice daily) (NCT01605227) who have disease progression after treatment with docetaxel chemotherapy and abiraterone (Zytiga) or enzalutamide (Xtandi).

Subscribers to premium content can login to read my analysis as to why I thought this trial would be negative.

Update Sep 1, 2014 COMET-1 is a failure

We normally put updates at the end of a post, but we’ve just heard the trial a failure, so I think it’s appropriate to put this upfront. Am glad that our analysis turned out to be correct. Congratulations to those blog subscribers who on the basis of this post sold all or part of their $EXEL position. Commiserations if you held on.