"Killing Cancer With Light-Sensitive Drug"
By Laura B. Benko
© Investor Business Daily, Feb. 24, 1997

Six years ago, Dr. James McCaughan faced a particularly difficult case: Cancer was eating away at a woman's lungs. Worse still, the disease was so far advanced that surgery was no longer an option.

Fortunately, there was an alternative.

McCaughan had the woman undergo photodynamic therapy, or PDT, an experimental procedure being pioneered by a small Canadian company called QLT PhotoTherapeutics Inc.

He injected her with Photofrin, a light-sensitive drug that selectively attaches itself to abnormal cells. Two days later, he used a catheter to shine a laser light directly on the tumors for about 30 minutes. The light triggered a reaction that killed the cancer cells without harming surrounding tissue.

Today, the woman is cancer-free. ''She swims laps at the Y every day, and she's 70 years old,'' said McCaughan, director of the laser center at Grant Hospital in Ohio. Without PDT, ''She would have been dead in six months.''

The treatment may soon be available to others suffering from the same condition. This month, QLT filed for U.S. Food and Drug Administration approval of Photofrin as a treatment for lung cancer. Approval could come by year's end, analysts say.

Prominent cancer centers, such as Grant Hospital and the Mayo Clinic, already use Photofrin to treat lung cancer and other diseases. FDA approval, though, is needed so QLT and its partners can promote the drug and patients can be reimbursed for treatment.

Photofrin, the only PDT drug on the market, got the thumbs- up from the FDA in December 1995 for late-stage esophageal cancer. But this disease affects only 12,000 patients a year, and the company is trying to broaden the market for the drug.

Lung cancer strikes more than 175,000 Americans each year. According to the American Lung Association, the disease killed 159,000 people last year, accounting for 27% of U.S. cancer deaths.

Photofrin, or porfimer sodium, is a chemically modified version of a substance culled from pig blood. It's marketed by Sanofi Pharmaceuticals Inc. in the U.S., by Lederle in Japan and by Beaufour Ipsen in Europe.

Most doctors who are familiar with PDT are sure it will take off - largely because it fits so well with today's cost-conscious medical climate.

PDT is less invasive and cheaper than surgery. The current treatment for lung cancer - the surgical removal of all or part of the lung - costs roughly $12,000 and requires five to 10 days in the hospital. PDT costs about $5,000, and patients can often go home the same day.

Plus, because Photofrin targets only abnormal cells, it doesn't cause the toxic side effects of chemotherapy and radiation therapy, such as nausea, diarrhea and organ failure. Its main side effect is a tendency for patients to sunburn, which can be avoided by staying out of direct sunlight for four to six weeks.

PDT's other advantage is that it doesn't preclude further treatment with cancer drugs or radiation, doctors said. They hope, though, the treatment will prevent the cancer from returning and spare patients the side effects of other treatments.

PDT ''will probably be a standard household term within 10 years. Everyone will know about it, just like they do surgery or chemotherapy,'' said Dr. Vanessa Schweitzer, who has treated several patients with PDT at Henry Ford Hospital in Detroit.

Already, the results seem remarkable. In Japan, 90% of patients with early-stage lung cancer had complete remission after PDT, studies show. Japan's national health insurance now covers Photofrin as a treatment for cancers of the lung, esophagus, cervix and stomach. France, Canada and Holland have approved the drug for more limited uses.

PDT, however, is proving to be more than just a cancer treatment.

Its most promising application, in fact, is for age-related macular degeneration - the most common cause of blindness in people over 50, said UBS Securities analyst Marc Ostro. The eye disease, called AMD, afflicts roughly 200,000 people worldwide each year, and current treatments help only 20% of them.

Early research shows that people with the disease had stable vision after treatment with QLT's light-sensitive drug benzoporphyrin derivative, or BPD. The treatment closes the abnormal blood vessels that cause AMD without further vision loss, which other treatments can cause.

BPD is in the final stage of clinical trials. Testing has gone quickly because so many patients are eager to participate in the study, said Ken Galbraith, QLT's senior vice president and CFO.

''There's a huge population of people who have been told that they will be blind in two or three years and there's no effective treatment for them,' Galbraith said. ''Just the demand to get into our study shows there's a big market for (BPD).''

QLT will test and market BPD with partner Ciba Vision Ophthalmics, a unit of Ciba-Geigy AG. Under the deal, Ciba Vision is funding 60% of the trials in exchange for 50% of the drug's sales. Ostro expects QLT to land solidly in the black by 1999.

For the fourth quarter, the comapny earned $4 million (Canadian), or 17 cents a share, compared to a net loss of $4.2 million, or 24 cents, a year ago. Revenues jumped to $10.9 million from $779,000.

For the 1996, it lost $4.7 million, or 19 cents a share, compared to a net loss of $14.7 million, or 77 cents, in 1995. Revenues rose to $13.5 million from $2.5 million. The stock, priced near 26, trades on the Nasdaq under the symbol QLTIF.

QLT is also testing Photofrin and BPD for skin, head and neck cancers, psoriasis, arthritis, clogged blood vessels and immune-system problems.

Other companies, such as PDT Inc., Dusa Pharmaceuticals Inc. and Pharmacyclics Inc. are developing similar drugs, but QLT has at least a two-year jump on them, Ostro said. What's more, each company is developing drugs to treat different diseases, so they aren't in direct competition.

Today, more than 40 sites offer PDT in the U.S. QLT's goal is to have 75 by year's end. The lasers, which are made by Coherent Inc. and Laserscope Inc., cost between $60,000 and $120,000.

The biggest challenge right now is education, Schweitzer says. ''Doctors don't want to change the way they do things,'' she said. ''A physician has to want to make the effort to learn.''