Theratechnologies Inc T.TH

RE:RE:Sutro’s Chinese partnership

[palinc2000]

I got stucked on the opening page with a big sigh of envy when I saw JANUARY 2022

qwerty22 wrote:

https://www.sutrobio.com/wp-content/uploads/2022/01/Sutro-Corporate-Presentation-Jan-9-2022-FINAL.pdf

They do have some interesting data which might be useful for our understanding. First off though I think that presentation is really great. There are some pages, like page 5, that really help you understand what's going on. 

I like page 15, it's an interesting way they both score receptor expression and deal with heterogeneity in the tumour. Their TPS score basically puts aside staining intensity which can be arbitrary, subjective and difficult to control and instead count % of cells that stain. They seem to have a pretty nice cutoff point of 25% of cells expressing receptor in order to show optimal effect of the drug. A year ago they were talking about staining intensity the way THTX is now so it's interesting to see they've changed tack on that one. Ultimately you go with what works, intensity might work for THTX, but there's an alternative there.

It's difficult to know the neutropenia situation. They are using a proprietary chemo warhead so hard to know exactly how toxic it is, how much sparing of white blood cells is happening by attaching it to an antibody. I don't actually think that chemo warhead has been given to humans in it's free form. Their animal work looks similar to THTX's in that very little cleaved chemo is detected in blood yet neutropenia is still a problem as Scarlett says. Maybe they have a hyper toxic chemo which is pretty harsh even a low levels in free form in the blood. THTX have a different scenario. Essentially docetaxel is their baseline, they have to beat that. I think that's why getting to 2x docetaxel equivalent levels was worthy of a PR. Being able to play in the 2x or 3x docetaxel equivalent range is a first win. Obviously that potentially improved safety profile needs to be paired with efficacy. Hopefully the next win.

Just a final though on Sutro's Ovarian cancer data. My understanding from listening to doctor is late-stage ovarian is pretty dire. You can see that highlighted in the baseline data. Their patients have gone from first diagnosis to last chance saloon in 2-3 years with only 2-3 line of treatment. It shows the real lack of effective treatment once first-line surgery/chemo fails. Ovarian cancer has been a drug development graveyard so any efficacy in that scenario is worth taking note of.

 

scarlet1967 wrote: They manage to strike a decent deal after their Phase1a. They did show efficacy but also their drug destroyed quite substantial amount of blood white cells. They had neutropenia related mortality and one can only assume despite all the safety issues the Chinese were still interested. Point is for late stage cancers it seems like the bar is lower in terms of results. It makes me think targeted delivery specifically PDC technology with some clinical advantages versus ADCs( smaller molecules, solubility, easier/cheaper to manufacture..)could attract quite a bit of interest from potential partners.