The Cell Game : Sam Waksal's Fast Money and False Promises--and the Fate of ImClone's Cancer Drug

Rating:
Summary: Reads like a novel, but it's a true story
Review: I could hardly put this book down. Never mind the Martha Stewart trial, this is where the excitement and drama in the ImClone story lies.

Sam Waksal, a scientist and business developer with a checkered past, lives a celebrity lifestyle, hanging out with the rich and famous, owning several fancy houses, driving fast cars, and heading a firm that is working on a cancer drug so promising that people with no other hope of treatment are flinging themselves at ImClone, begging for a merciful dose of "Erbitux."

The drug apparently does reverse inoperable tumors in a few test patients who had no other hope of living. Now the race is on to fast-track the drug through the FDA approval process based on the glowing clinical trials. But the FDA reviewer is unaccountably unencouraging when meeting with one of ImClone's top scientists. What is wrong? Is Erbitux, instead of being approved , instead going have its application refused? Why! And what will this mean for the high-flying ImClone stock?

The book reads like the best thriller, and author Alex Prud'homme is adept at making you feel like the proverbial fly-on-the-wall during the action. If you are at all interested in what happened behind the Martha Stewart debacle, you must read this. It's fantastic.

Rating:
Summary: Lively character study about Sam Waksal - needless tragedy
Review: This book is a fine character study of an amazingly talented man whose endless need to gratify his own appetites and emotional needs led him to careless and even cruel behavior. There is no denying the great talent of Sam Waksal, but to this day he doesn't seem to understand that his talent and accomplishments do not provide a license to indulge himself at other's expense.

It is amazingly sad that all of this misery was so pointless because Erbitux has at last been approved. It almost certainly could have been approved earlier if the talented team at ImClone would have had a culture of discipline and getting things done and documented in ways that everyone knew the FDA required. If they had, all this pain and loss would never have occurred and Dr. Waksal would be a real hero instead of the one he only pretended to be.

Mr. Prud'homme writes with style and vitality. The book moves along well and has a great feel for keeping the story personal and emotionally accessible for the reader. We don't get overwhelmed with the scientific side of things, although it is always interesting to read about this emerging science and the wizards who are making it happen.

Rating:
Summary: Lively character study about Sam Waksal - needless tragedy
Review: This book is a fine character study of an amazingly talented man whose endless need to gratify his own appetites and emotional needs led him to careless and even cruel behavior. There is no denying the great talent of Sam Waksal, but to this day he doesn't seem to understand that his talent and accomplishments do not provide a license to indulge himself at other's expense.

It is amazingly sad that all of this misery was so pointless because Erbitux has at last been approved. It almost certainly could have been approved earlier if the talented team at ImClone would have had a culture of discipline and getting things done and documented in ways that everyone knew the FDA required. If they had, all this pain and loss would never have occurred and Dr. Waksal would be a real hero instead of the one he only pretended to be.

Mr. Prud'homme writes with style and vitality. The book moves along well and has a great feel for keeping the story personal and emotionally accessible for the reader. We don't get overwhelmed with the scientific side of things, although it is always interesting to read about this emerging science and the wizards who are making it happen.

Rating:
Summary: Lively character study about a needless tragedy
Review: This book is a fine character study of an amazingly talented man whose endless need to gratify his own appetites and emotional needs led him to careless, and even cruel behavior. There is no denying all that Sam Waksal was capable of, but to this day he doesn't seem to understand that his talent and accomplishments weren't enough. He also hurt a lot of people.

It is amazingly sad that all of this misery was so pointless because Erbitux has at last been approved. It almost certainly could have been approved earlier if the talented team at ImClone would have had a culture of discipline and getting things done and documented in ways that everyone knew the FDA required. If they had all this pain and loss would never have occurred and Dr. Waksal would be a real hero instead of the one he only pretended to be.

Mr. Prud'homme writes with style and vitality. The book moves along well and has a great feel for keeping the story personal and emotionally accessible for the reader. We don't get overwhelmed with the scientific side of things, although it is always interesting to read about this emerging science and the wizards who are making it happen.

Rating:
Summary: A GRIPPING YARN!!!!
Review: This book is beautifully written and the story is powerfully, artfully told. Alex Prud'homme's eye for telling details and anecdotes brings to life all of the egos, greed, outsized appetites, and fat wallets that intersected in Sam Waksal and Martha Stewart's world. I couldn't put it down.

Rating:
Summary: The Waksal-Stewart Connection
Review: This fascinating story has appeared just as the Martha Stewart trial is getting underway. The book is crammed full of details not only concerning the principal characters, but also cancer treatments and the burgeoning world of biotechnology. Sam Waksal comes across as a mercurial salesman with no true sense of right or wrong, a classic striver seeking recognition and aspiring to great wealth, but also dissing the hopes of many with cancer. It's a good read -- fast-paced, up-to-date and accurate. If you really want to know why Waksal is in jail for seven years and how Martha Stewart became involved with his world, read this amazing and well-researched tale.

Rating:
Summary: Compelling tale about greed and how the system works
Review: This is about the Cancer Game, which might be seen as a part of the Cancer Industry, a kind of bizarre and ghoulish phenomenon of modern times that exists precisely because there is no cure for cancer. Indeed, Alex Prud'homme, who is a gifted researcher and prose stylist, whose work has appeared in such prestigious journals as The New Yorker, Vanity Fair, The New York Times, etc., might very well have called his book "The Cancer Game." I wonder why he didn't. Would such a title have offended those who play the game?

It is specifically about the rise and fall of one Sam Waksal, oldest son of Jewish emigrants and Holocaust survivors, a man of irresistible charm, fabulous energy, and great intelligence, a man driven to success and the high life, a man who had bounced around academia without much success until in the 1980s he saw an opportunity to become a player in the cancer game, and, along with his younger brother Harlan, founded ImClone Systems, Inc.

It is also about an anticancer drug called Erbitux, originally known as C225 because it was the 225th drug tested by its discoverers, John Mendelsohn and Gordon Sato in 1980. It showed promise because in tests it stopped the growth of tumors in mice.

And finally it is a story about how drugs get discovered, how they are developed, and especially how they get approved (or not) by the Food and Drug Administration. And of course it is about the Byzantine and incestuous relationship that exists between that August government agency and the massive pharmaceutical industry.

The curious thing about all this is that Imclone never turned a profit, Erbitux never came to market, and most of the people associated with Waksal and ImClone either made out like bandits or got stuck holding the bag. The drug itself, which works against cancer tumors, particularly colon cancer, by cutting off the blood supply to the tumors (an "antiangiogenesis" drug), was touted as a miracle that would save the lives of innumerable patients and make possibly billions of dollars for ImClone.

At least this was the hype delivered by Sam Waksal, and bought hook, line and sinker by pharma giant Bristol-Myers Squibb, and by desperate cancer patients as well as salivating Wall Street investors who jumped on the bandwagon as ImClone's stock rocketed skyward. Because of the promise of the drug, Waksal himself was able to live his dream life as a New York socialite, throwing lavish parties for celebs (including Martha Stewart while he dated her daughter), collecting fine art, popping open $600 bottles of Chateau Lafite-Rothschild while secretly selling stock on the side, sending the proceeds overseas, buying expensive apartments and houses for himself, etc., etc.

But the cold hard facts of Erbitux, like those of almost any cancer drug one can name, are very far from the hype. As Prud'homme notes on pages 332-333, "these agents...[Erbitux and others like Avastin and Iressa] are remarkable scientific advances, [but] they still only benefit some 10 to 20 percent of patients, and they only extend patients' lives by a matter of months."

That's it. That's the bottom line. And yet these drugs are so valuable that the companies that end up selling them can make hundreds of millions if not billions of dollars.

Waksal apparently came to this understanding sometime during the early eighties. He realized first the simple fact that the way the cancer industry works is doctors have to prescribe something rather than nothing. Then he realized that living a few months longer can mean a lot to people. Therefore any FDA-approved cancer drug will automatically fill a need. What this means is that the PROMISE of a cancer drug, if cleverly promoted, will spark a rally in the shares of the company that owns the patent. If, like Sam Waksal, you own millions of those shares, you can get rich on mere promise alone.

Furthermore, should the drug have any real value at all, and be approved (or even look like it's going to be approved) by the FDA, you might be able to get some pharmaceutical giant like Bristol-Myers Squibb to front a whole lot of money on that promise since they are desperate to find a cancer drug to replace those that have gone generic.

This works because even drugs with very limited effectiveness are better than no drug at all. This is true for many patients, for many doctors, and is especially true for the big pharmaceutical companies.

Note that these drugs are valuable because the people who need them are typically people of relative means who can afford to pay large sums of money for them, either through their HMOs, their government, or their own funds. In contrast a drug that would prolong the life of poor people in third world countries would be of only marginal value to the big pharmaceutical companies.

I should also mention that Prud'homme spends some serious ink in this book on Waksal's long-time friend Martha Stewart and her troubles. Her personality, her empire, and the way she handles herself are vividly detailed. In fact, some readers might find her story the most interesting part of the book.