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Bullboard - Stock Discussion Forum Theratechnologies Inc T.TH

Alternate Symbol(s):  THTX

Theratechnologies Inc. is a Canada-based clinical-stage biopharmaceutical company. The Company is focused on the development and commercialization of therapies addressing unmet medical needs. It markets prescription products for people with human immunodeficiency viruses (HIV) in the United States. The Company's research pipeline focuses on specialized therapies addressing unmet medical needs... see more

TSX:TH - Post Discussion

Theratechnologies Inc > Designing the basket trials
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Post by scarlet1967 on Oct 16, 2022 10:49pm

Designing the basket trials

There are various designs for basket trials and the company hasn’t released any details for their phase1b trial. As per FDA master protocol’s guidance each subgroup’s safety will have to be evaluated individually if necessary corrective actions etc.

There is also potentials for information borrowing across subgroups, effective statistical analysis, time and cost savings for certain types of basket trial(Bayesian designs). I am sure the CROs/sponsors would choose the best design for the trial. 

Point is trying to interpret and make anticipations for every sentence every word from the company can be quite premature not knowing the real reason again as far as we know the phase1b is ongoing, patients are being enrolled in whatever pattern based on a logical explanation which will supports the overall purpose, “less complex yet more effective basket trial”. 

 

 

 

 

 

The Benefits of Using Basket Studies in Oncology

 

Basket trials are quite flexible in terms of design; they can be Bayesian, Frequentist, Adaptive or a mix of any of these. Bayesian basket trials are flexible and efficient as a range of design elements can be explored and implemented. However, there is a trade-off between efficiency and complexity. The complexity of basket studies leads to challenges around the study design, statistical modeling and analysis, statistical properties, and operational considerations.

In a recent Cytel webinar on Expanding Applications of Master Protocols, James Matcham, VP Strategic Consulting at Cytel, presents on how the statistical approaches have developed from treating each indication separately, to Bayesian designs where information can be shared among indications to reduce overall sample size, time and costs.

 

https://academic.oup.com/biostatistics/article/23/1/120/5831921

 

Most recently, more sophisticated methods in the framework of Bayesian model averaging (Madigan and Raftery, 1994Draper, 1995) have been applied to analyzing basket trials. Psioda and others (2019)average over the complete model space, which is constituted by all models for possible configurations of the subgroups that may demonstrate the same or disparate efficacy. In a model that assumes identical treatment effect among specific subgroups, information is pooled across the corresponding subgroups under the assumption of inter-patient exchangeability.

 

 

 

 

 

https://www.iconplc.com/insights/blog/2022/06/14/using-bayesian-based-model-assisted-designs-in-early-phase-oncology-trials/

 

Studies that want to test a drug in patients with different types of cancer may also benefit from deploying basket designs within a master protocol when obtaining preliminary efficacy data. Extracting information across cohorts can also improve the efficiency of the statistical analysis using a Bayesian framework. As oncology therapeutics and early phase design models evolve, sponsors will benefit from working with a partner experienced in innovative adaptive designs for phase 1 and 2 oncology trials.

Comment by palinc2000 on Oct 17, 2022 9:00am
Very helpful !!! THTX is dealing with very complex issues and for sure each new day presents its own set of challenges Again eveyone needs to calm down  
Comment by SPCEO1 on Oct 17, 2022 10:27am
And TH needs to explain these things more clearly too. It is hard to understand why they don't set expectations better. They know everything about the phase 1b trial design and the limitations it brings with it - why not spell it out for investors instead of saying they think they have the key to cancer and they will have results between mid-August and Christmas? Why go quiet for 6-8 months ...more  
Comment by qwerty22 on Oct 17, 2022 1:00pm
You are getting very frustrating. You want expectations set better but below I pointed out that Christian in one of his comments took the data release right out to the end of Ph1b and you dismissed it as an "after thought". You seem to accept that the company has set the standard of two confirmed responders in one cancer type before they begin talking about the ongoing trial yet you ...more  
Comment by qwerty22 on Oct 17, 2022 1:04pm
I mean the brutally honest version of the "key" comment would be  "We think we have the key but so did the 94% of oncology drug developers who failed to get approval" Does that work for setting expectations?
Comment by ANALIAS00 on Oct 17, 2022 1:22pm
I fully agree with that statement.
Comment by palinc2000 on Oct 17, 2022 4:08pm
"We think we have the key but so did the 94% of oncology drug developers who failed to get approval EVEN THOUGH THEY HAVE SPENT BILLIONS AND HAVE BEEN ONCOLOGY GRUG DEVELOPERS FOR MANY MANY YEARS
Comment by Biobob on Oct 17, 2022 4:20pm
At least we don't have billions of phony valuation backing Th1902... it's priced at sweet nothing atm... ok we can go down stupid on failure but Thera is cashflow positive if it scraps all the pipeline spending... can't say as much for most of biotech cos... 
Comment by SPCEO1 on Oct 17, 2022 4:55pm
And sales growth has seemed to be reinvigorated so investors might actually be willing to pay something for it. Probably not as much as we would like but it does offer downside protection if they can keep that progress going. If tomorrow TH reported that cancer was a dud, analysts would not likely change their price targets on the stock as they do not yet include anything for cancer. It will be ...more  
Comment by PinnacleX on Oct 17, 2022 6:36pm
Do you really believe in some of the things you write?  its so crazy.  So in your head sales growth has seemed to be reinvigorated?? lol how? no evidence of that whatsoever. And if Cancer was a dud analyists wouldnt change anything LOL just laugabale.  Go plug in some numbers and get a valuation for this company with its current EPS and youll see that this thing is still about a ...more  
Comment by Biobob on Oct 17, 2022 7:27pm
You never know what's going to happen.  Who tought Egrifta would be approved after the panel meeting back in 2010... nobody i can tell you.  I saw massive insider purchases and overly optimistic behavior from CEO's just before complete implosion of many former biotech darlings.  I saw insiders sell their holdings in companies just before takovers and lose millions in the ...more  
Comment by Wino115 on Oct 17, 2022 8:32pm
We can do without the slurs, please. One can argue the  sum of the parts valuation many ways, but the ongoing business would be valued at less than 2.6x revenues which is on the lower end of biotech ranges. Most, with similar kinds of mixed revenue and pipeline assets, trade higher. I think it would only be negatively affected if safety became a bigger issues (which I don't see happening ...more  
Comment by PWIB123 on Oct 17, 2022 9:02pm
SPCEO1 is making me nervous. I think I'm encouraged that the scientists are seemingly getting more comfortable and satisfying themselves with speculative plausible explanations for gaps in understanding. I just cannot get over our legal counsel selling, considering he has to be privy to many details. He used the words, got burned in the past. There is still a huge amount of uncertainty in my ...more  
Comment by LouisW on Oct 17, 2022 10:09pm
I am a scientist working in the bioindustry for almost a decade. I think the known data so far is convincing. In my past experience, it is normal to see delay of clinical trial progress in biotech companies since there are a lot of uncontrolled factors affecting the progress. I own 120,000 shares and i have patience. On the Q3 meeting, Paul said that many companies have contacted them regarding ...more  
Comment by PWIB123 on Oct 17, 2022 10:20pm
I appreciate this point of view. I remember Paul saying something to that extent and didn't think of it in terms of partnering too early versus holding out for a bigger payday. That does feel bullish.
Comment by Wino115 on Oct 17, 2022 11:00pm
The correct strategic decision would be for you to learn as much as you can through this fairly inexpensive capitalization of your asset (P1 costs $10mil, a P2 for one cancer $15-20mil maybe, just guessing).  They can afford to see just how commercial it could be and what the potential is and then partner in a few geographies where they will never operate.  Later they can partner in more ...more  
Comment by PinnacleX on Oct 18, 2022 2:32am
Appreciate the honesty
Comment by canadapiet on Oct 18, 2022 4:11am
Yeah right.....,  like the many partners he is claiming interested in their Nash program for years now.....!!! It is an open lable trial, be sure that if the results were "astonishing", big pharma would be all over them...!!!! But some are right that shareprice is low with 1) what they have and 2) trying to have! So limit orders are back in, who knows i am becoming again a ...more  
Comment by SPCEO1 on Oct 18, 2022 9:41am
From my perspective, which could be incorrect as it often has been previously, it is appropriate to be more concerned about the TH-1902 efficacy outcome now. No one should be totally freaked out because there is plenty of time left to get to the result we are hoping for, but by not adding anything factual to our knowledge about TH-1902's safety or efficacy with the third quarter results - five ...more  
Comment by jfm1330 on Oct 18, 2022 10:42am
I was so disgusted with the press release last week that I just listen the parts of the CC. Today I listened to the whole thing. The thing that struck me was their planned refusal to talk about anything from the actual trial, especially enrollment numbers. Why would you fear so much to talk about enrollments numbers? I saw only two possible answers, first, they are very late again like in phase Ia ...more  
Comment by jfm1330 on Oct 18, 2022 10:59am
Other interesting bit from Levesque near the end of the CC answering Doug Loe about TH1904 and the possibility of pushing other PDCs into clinic. Levesque said: "At this point we want to be laser focused in accelerating the recruitment of patients as part of the basket trial." So again, it points to problems in enrollment pace. Put it in other words, our recruitment pace is too slow, we ...more  
Comment by Momo25 on Oct 18, 2022 10:06pm
Th is good at playing shareholders.
Comment by palinc2000 on Oct 18, 2022 11:07am
IF in fact recruitment is low the worst thing the company could do would be to publicize it!!!That would only make it more difficult to recruit .Dont need to be a genius to figure that out!!! Not only is The Company opening up 6 new sites but they also confirned that full enrolment will be on target to be completed by end of Q1 2023 which is the original target The rest is just a matter of ...more  
Comment by SABBOBCAT on Oct 18, 2022 11:11am
I was similar to you im my interpretation but with one other point: we are 7 weeks out from annual option grants. No need to upset the status quo before then. My take is enrolement is slow, but they are seeing good signs. History says they like to sit on info and make a big splash, so if they are seeing promising results in 1-2 cancers, they may be waiting to announce signs in 2-4 in a few ...more  
Comment by Biobob on Oct 18, 2022 11:18am
Makes a lot of sense... it would be stupidity for them to act otherwise if they can.... maybe they are not that stupid after all...
Comment by PWIB123 on Oct 18, 2022 11:36am
Believe it or not jfm1330, if slow enrollment is the issue with not seeing efficacy, that gives me comfort as compared to some other issue that isn't overcommable.  As has been pointed out here already, the trials are messy, patients are in poor health, and the effort required from the patient just to keep up with the trials helps me get comfortable with challenges in enrollment, because ...more  
Comment by Wino115 on Oct 18, 2022 12:21pm
The other issue with these kind of trials for refractory, last stage patients is they can enroll them, but they just don't get much beyond 2-3 cycles and not a whole lot occurs.  Many reasons for these types of patients to discontinue as we know first-hand and you allude to. I can easily see that as one of the difficulties in these extended patient enrollment trials. You probably have to ...more  
Comment by ANALIAS00 on Oct 18, 2022 12:45pm
I love this post ! :o)
Comment by SPCEO1 on Oct 18, 2022 3:25pm
I liked it as well
Comment by qwerty22 on Oct 18, 2022 5:52pm
I think this is mis-reading the comment about new centres. He didn't express any urgency around this. He didn't actually say they were looking to get centres opened quickly, he said they were doing paperwork. That expresses no urgency to me whatsoever. My memory of doing that particular task is it's a multi-layered bureaucratic process and there's no rushing it even if you wanted ...more  
Comment by ANALIAS00 on Oct 17, 2022 5:29pm
I fully agree with that additional statement. <.></.>
Comment by PinnacleX on Oct 17, 2022 4:36pm
Then we have this loser that sits here and makes a post every 20 mins.  Get out your moms basement, get off Stockhouse.  How pathetic are you to just sit infornt of your screen all day and make yourself feel better by quaoting your own  posts? 
Comment by SPCEO1 on Oct 17, 2022 5:33pm
I actually copied Christian's quote and he said both the end of the current quarter and six months. That is actually a mixed message and not good expectations setting.  I suspect Christian thinks they will have something by the end of this year and only added the six months part because I think Paul had extended the timeline for TH-1902 earlier. I think you may have mis-interpreted my  ...more  
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