jfm1330 wrote: So we will have another fireside chat with the CEO on August 11, and at that time they should be at twice the MTD of free docetaxel, either well into it or just starting it. So to see Levesque willing to participate in such a public event at that point is a very good sign that they are still on the right track.
I will repeat myself, because it is very important to clearly understand the actual process and the way Levesque is behaving, but the company already knows the basic pharmacokinetics of TH1902. In other words, they know how much free docetaxel is generated in the bloodstream, over time, after the PDC is injected. So they are already able to have a good idea of the possible MTD, because toxicity is mostly related to the concentration of free docetaxel, over time, in the bloodstream. The key parameters are peak concentration, and the area under the curve. Area under the curve allows to evaluate the total quantity of free docetaxel that ended up in the bloodstream in given period of time.
So all that to say that Marsolais and al at Thera are not flying blind at the moment. They have a good idea of what is going on with the PDC and of where the landing spot (MTD) will be. They don't know exactly where it will be, but they have a ballpark figure and it seems like it will be a good number.
jfm1330 wrote: I went back to the KOL presentation to determine at what dose Thera likely is right now in the dose escalation trial. Marsolais said it take three to four weeks for every cycle. It was annouced on March 23 that they injected the first patient of the trial at 30 mg/m2. So taking that date as the starting point it gives this assuming a full four weeks for every cycle, which is likely not the case, especially in the first two or three cycles. Anyways, it gives this
March 23: 30 mg/m2
April 20: 60 mg/m2
May 18: 120 mg/m2
June 15: 200.4 (on June 21, Marsolais said they were close to the MTD of docetaxel of 230 mg/m2. So this is in line with what he said then)
July 13: 300.6 mg/m2
So it gives July 13 for the first dose well above the MTD of free docetaxel. Again, Marsolais said three to four weeks per cycle, so more than three weeks, but in some cases, probably in the first cycles, with one patient, less than four weeks. So this dose of 300 mg/m2 has been likely given somewhere between July 5 and July 15. Likely in the middle of that interval. So it is easy to understand why Marsolais willing to say in the last CC that they will surely have a MTD of TH1902 that is higher than the MTD of free docetaxel. Also, he probably already had the dosing of free docetaxel over time in the blood after the injection of the 300 mg/m2 dose. So he knew the level of free docetaxel this dose was generating. If the number was as low as expected, it confirmed to him that toxicity at that dose was very unlikely.
The next step will be 420 mg/m2 on August 10. This will be close to two times the MTD of free docetaxel.
Then, if they get there, it would be 558.6 mg/m2 on September 7, and 742 mg/m2 on October 5. This would be a bit higherthan three times the MTD of free docetaxel, which is what they saw on rats in the preclinical.
So we are sure to have a significantly higher MTD of docetaxel with TH1902. At this stage the only question to answer is how much higher will it be. The higher it will be, obviously, the better it will bode for efficacy. This helps understanding why they are so confident with TH1902 anf the SORT1 approach in general. Why they hire people to coordonate preclinical and clinical work. It also allows to understand why they were willing to write in their last press release, and say through the CEO in their last CC that they believe that They have developed a targeted peptide-drug conjugate that may potentially transform the way cancer is treated. These are their words, not mine, and this is a very bold statement coming from them. I can't figure how they can be more positive than that without releassing real good results. After such a statement, coming out in a few months with negative results would be an absolute surprise. But again with this company at this time, it is a matter of credibility and they obviously don't have much with the market. So this statement went by like it was never made. Even here, I have been the only one underlining it. So we will have to wait for the real results. It will either be a shocker for many, or a big disapointment for me.