RE:RE:RE:RE:RE:Full report from Doug LoeNot disagreeing with the usefulness of a screening tool at some point. But the (putative) secondary MOAs we talked about, VM disruption and IL-6/Progranulin pro CSC effect might not need significant Sortilin over expression.
We could still see responses in terms of SD which are very valuable for aggressive cancers.
jfm1330 wrote: According to their Investor Day presentation, only 30% of pancreatic and colorectal cancers are overexpressing the Sortilin receptor. In my view they cannot go in phase II in these without a screening tool. Biopsies and histology tests would do that job, but it is hard to imagine biopsies being done on advanced cancer patients just to participate in a clinical trial. That with just 30% of chances to be eligible for the trial upon results. In phase I, given the small number of patients, maybe they will be able to find patients that already had biopsies made and do the histologiocal testing on frozen tumor parts. I don't know. With 30% prevalence of receptor overexpression, they cannot avoid screening. When prevalence is 80-100%, like in ovarian, endometrial cancers and melanomas, maybe they can treat without it, but not at 30%.
Wino115 wrote: Right, and I would assume TNBC is lead but that they would rank pancreatic and ovarian pretty close behind based on large population of unmet need. I suppose you could say the same for colorectal, but like you say, they can't do it all in the first trial. They can clearly tackle them quickly thereafter and will be trialing TH1904 at some point. I guess you go for the ones where the response rate is over a certain hurdle of response.
I am guessing the strategy is to go for the most prevalent but hardest to treat with unmet need so that you get all the accelerated approvals and breakthrough therapy designations. Then do the others right in the background until those are completed. That's where you could partner an indication out if you want someone else to run with it and it's a relatively smaller indication.