As a biotech junkie, I’ll admit I was shocked to the core by Dendreon Corp.’s second-quarter admission that prostate cancer vaccine Provenge (Sipuleucel-T) is thus far not succeeding commercially.

(See BioWorld’s news bulletin for details.)

The most shocking part? Analyst and investor assumptions that Provenge’s poor performance is due not to reimbursement hurdles, as Dendreon claimed, but to an underlying lack of demand. Doctors and patients don’t want to use the product.

Come again? Are you serious? Provenge is the first and only therapeutic cancer vaccine ever to gain FDA approval. I don’t have to tell anyone in the biotech industry what a big deal that is, or how many other cancer vaccine companies tried and failed, or how many hurdles Dendreon had to clear to get that FDA approval. This drug was supposed to revolutionize how cancer is treated – finally, we could use a vaccine to trigger a long-term immune response in which our bodies would fight the cancer for us! While I try to avoid hype, it was hard not to get excited about Provenge.

Which is why it strikes fear in my heart to hear that maybe, just maybe, doctors and patients aren’t all that interested. They are not impressed by one of the most exciting mechanistic advances in cancer care that biotech scientists could churn out.

Granted, Provenge has issues. Its four-month survival benefit is not awe-inspiring, and its $93,000 price tag is by no means cheap. This delicate cost-benefit balance is an issue for most biotech drugs, but it hasn’t proven an insurmountable hurdle in most cases.

It’s still early days – if there is one thing Dendreon’s implosion has taught us, it’s that no one can predict how this drug will perform in the future. Maybe sales will pick up.

I hope so, because the alternative – that folks no longer see the value in the best medical advances the biotech industry can crank out – is disheartening to say the least.