Theratechnologies Inc T.TH

Sad news

[jeffm34]

I think this might be TH's first patient in the cancer trial. Condolences to his family. 

https://www.gettysburgtimes.com/obituaries/article_cb4e3798-3083-5062-9b44-9fd624857194.html

[juniper88]

My condolences to his family also.  Sad news indeed.

[scarlet1967]

Sad, my condolences to his family and love ones, it shows how desperately these grade 3 or 4 cancer patients need a treatment.

[juniper88]

This came as a shock to me, especially when you consider one of the inclusion criteria of the trial: "Have an expected survival of at least 3 months."  

[Lee430]

Cancer has touched too much of my family so when when I hear another sad cencer story it reminds me to stop, re-center and be grateful for what I have at this very moment...."it is called the present becouse it is a gift"

[scarlet1967]

    Apparently this gentleman was battling with prostate cancer for five years, the average five year survival rate for stage 4 prostate cancer is only 29% so he must have been a very sick at the start of the treatment, although the inclusion criteria is “expected 3 months minimum survival “ for late stage cancers I believe it is hard to predict that.   https://zh-tw

[SPCEO1]

I believe he was first dosed in early March so he likely survived very close to 3 months.

[SPCEO1]

I was not surprised - he did not look very good in the newspaper account. I actually had checked for his obituary a couple of days ago thinking it was possible he may have passed. We also sensed something was amiss early on as it seemed the second dose took longer than it should have to administer. Plus, prostate cancer was not an expected early target for TH-1902. Still, it is very sad that he TH

[Bucknelly21]

So very sad, I also wish for his family to find peace.

[Bucknelly21]

What does this mean for th1902

[Wino115]

For this phase of the trial not much. It's about dosage and then safety and efficacy. But sounds like he likely never got up to a therapeutic dose level.  Someone earlier on pointed out the difficulty of all-comer trials for a fourth line treatment where nothing has ever helped the patient.  In those conditions, one has to expect numerous issues such as this can ultimately occur

[jfm1330]

This is the reverse side of the publicity made on the first dosing on this patient. It also put forward the question as to why they are not testing patients for sortilin overexpression on tumors before selecting them? In this case, it was even worse, they took a type of cancer that was never in their list of cancers with possible sortilin overexpression. Also, the doses that he was given are the

[LouisW]

Yes. Totally agree. Since garbage in, garbage out.

[scarlet1967]

We are talking about human beings not garbage

[juniper88]

I have spoken with Christian before and he seems quite serious to me.  I believe he and his team know what they are doing.  The standard for these Phase I cancer trials is have all comers participate.  There is probably a reason for that.  As for Mr. Snyder, in the interview he gave, he hinted at his altruistic reason for participating in the trial.  Even though we do not

[qwerty22]

"There is probably a reason for that". JFM is just not contemplating that, he's stuck with a single thought in his head. Excellent comment both about Mr Snyder and how this trial is formulated. I'm not sure how JFM remains invested if he thinks they are making major mis-steps in their trial designs.

[jfm1330]

Contrary to some here I never suggested that people in Thera's management were incompetents. That being said, I don't understand why they are not selecting patients with sortilin overexpression on their tumors, even in the dose escalation part of phase I, because the toxicity of the drug will not be the same depending on sortilin overexpression or not. If you understand the principles of

[qwerty22]

If you're unwilling to engage with some ideas that might explain why they do this then maybe we should just live with the fact that you "don't understand" and move on. You assume so much, and so much of what you assume is wrong. There is absolutely no evidence that the drug distribution will differ all that much between SORT1+ and SORT1- patients. That's your assumption

[qwerty22]

You can't have it both ways. If anything you say here is true then THTX management ARE incompetent. Fortunately you're wrong and they aren't. None of what you say here is correct. In SORT+ patients only a tiny proportion of the drug (less than 1% probably) interacts with the tumour. That amount of drug makes little difference to the amount of circulating drug in the blood. And just

[qwerty22]

It's a shame you have me on ignore because a discussion about this might get you past this point rather than have you repeat it over and over. Not just that but right now you are assigning failure in this patient to something (lack of SORT1 screening) that can just not be proved the cause of this failure. The patient was receiving sub-therapeutic levels of the drug, his death suggests his

[palinc2000]

You are not  really on his ignore list,JFM just pretends that you are so he does not have to argue  to backtrack when caught wuth his pants down so to speak!! He thinks he has a monopoly on truth and expertise,. I agree with Juniper that THTX is taking this trial very seriously 

[scarlet1967]

I don't believe this is relevant to trial's progress in terms of success or failure, as we are only few months into trial it's all about MTD and potential early efficacy, I just don't get why they don't expand the life expectancy a bit more so these patients can potentially get some therapeutic benefits?

[qwerty22]

It's a personal tragedy but it's hard to think it means much for the trial. If he's passed away now it's easy to think his disease has been progressing for most of the time he's been on the trial, he may have even come off the trial after 2 or 3 doses because of that. Even if he was on the trial up to the end it's also easy to think he's only been mostly receiving sub

[jeffm34]

I wonder if this changes the messaging on the 21st? 

[Wino115]

No cancer trial depends on 1 patient, even the first.  It's the law of large numbers. They all have deaths and that's factored in, especially for metastatic cancers with no options and refractory to any treatment.  That's why there's roughly 10 people slated to get to the max dose and then 40 to try that MTD for safety.  Then you move on to 60-150 in Phase 2.  

[scarlet1967]

They need to increase the life expectancy as it is now the therapeutic benefits of their drug absent any toxicity could start at forth cycle or later each cycle takes 3 weeks a total of minimum 3 months before any potential efficacy so these patients won't see any benefits due to a narrow window for the drug to work. In my opinion as per current design few first patients who enrol pretty much

[juniper88]

Thera could have specified a 6 month life expectancy instead of 3.  Then a person with that life expectancy would more like have gotten a therapeutic dose.  However, Mr. Snyder who's life expectancy was probably less than 6 months would never have been on the trial. I believe right now any new patients would be getting a therapeutic dose.

[scarlet1967]

That's the point Mr.Snyder and others with short life expectancy won't see any therapeutic effects so to me they are used as samples if they increase their minimum to even 4 or 5 months at least those patients have a chance of some therapeutic effects if and when the drug works. Again I am not an expert but why not design the trial so they can get results and help patients. I do also

[qwerty22]

Can you make that sort of fine distinction between 3 and 6 months? Presumably if a certain cancer at a certain stage has a life expectancy of 6 months then within that statistic there are some people who will hold out for 9 months and some that will succumb in 3. Is it possible to predict which path an individual patient will take? It seems like the life expectancy criteria is just to rule out

[scarlet1967]

I agree it's hard to predict the progression for late stage cancers specifically when the patient has been diagnosed 4 or 5 years ago and I do understand they don't want to not enroll patients which most likely won't respond so they won't include patients with less than 3 months of life expectancy and that is the reason I believe they should increase the min life expectancy. If

[juniper88]

I don't believe it is easy to make that distinction.  I believe you are right why the trials ask for mininum 3 months.  My point was that if you do make it longer than even more patients would not get the experimental treatments at all.  Ethitics is kind of a difficult thing in this situation.  Btw, my wife was told in 2019 she had less than 1 year to live.  Obviously

[canadapiet]

Juniper88: Btw, my wife was told in 2019 she had less than 1 year to live.  Obviously, their estimates are not always right. Great to read that!! Finally some positive news! Live is a mystery and it is a blessing to be here now! The "present" is a  "God gift"!  Really hope you can enjoy life for many years with the one you love! Good luck all!!

[SPCEO1]

Thank God for that!  In all such matters related to early cancer trials, the people putting them together make their best guesses and soldier on through the variable responses. TH-1902 is blazing a new trail and the chances that the trial design will later be deemed to have been absolutely perfect for the situation are pretty low. If they got it generally right, that should be good enough

[scarlet1967]

One of our dear family friends was battling with prostate cancer for years his condition worsened rapidly during last two months of his life , he got admitted to hospital during the last month as the cancer was spreading causing pain he was administered with Morphine progressively so the last week he was mostly at sleep and last couple of days in coma. it is sad to see how cancer end life of

[qwerty22]

Here is a paper that specifically investigates this 3 month life expectancy issue. https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-11-426 The first thing to note is 3 months is standard across trials. Next a quarter to a third of patients assessed don't meet this criteria so don't get enrolled. And 20% of patients that do meet that criteria and get enrolled die before

[scarlet1967]

As for the trial the question is at what point did they stop dosing this patient, the potential efficacy could only start at about forth cycle or later. Often cancer patients stop treatment during last few weeks  of predicted mortality. They will be administered with strong analgesics like morphine during last few days the patient end up in coma. So the three months life expectancy leave the

[Wino115]

Well said.  I suppose it was a timing issue and had this been available a year ago, it might have helped better.  Not much you can do once it's highly metastasized, especially with the low doses he was given .  RIP  

[LouisW]

The SORT1 expression level is so low. I wasnt surprised. But personally I am very interested in the result if Th1902 can conquer melanoma cancer cells in patients.