Biotech Values

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GTHX, OMED, tarextumab > There were some differences between the 2 trials...

GTHX/Trilacicib's patients were worse off. The inclusion criteria was ECOG 0-1 for tarextumab and ECOG 0-2 for trilacicib.

Oncomed's trial placebo vs. trilacicib's historical comparison is not apples to apples. OMED's trial placebo regimen included Cisplatin. GHTX's used Carboplatin. Cisplatin has show a higher response rate than carboplatin in meta-analysis. I couldn't find any recent SCLC trials with EP/carboplatin and the same regimen as used by GHTX to compare it with. I did go back and find the same trial they cited/compared and the regimen is exactly the same so the 88% vs. 52% ORR is meaningful IMO.

Meta-analysis of randomized clinical trials comparing Cisplatin to Carboplatin in patients with advanced non-small-cell lung cancer.

https://www.ncbi.nlm.nih.gov/pubmed/15326195

Subgroup analysis revealed that combination chemotherapy consisting of cisplatin plus a new agent yields 11% longer survival than carboplatin plus the same new agent (hazard ratio = 1.106; 95% CI, 1.005 to 1.218; P =.039).

CONCLUSION:
We found that combination chemotherapy consisting of cisplatin plus a new agent yields a substantial survival advantage compared with carboplatin plus a new agent in patients with advanced NSCLC, although we failed to find any survival difference in an analysis that included both new and old agents. The strength of our conclusion is limited because we used abstracted data, and careful interpretation is thus required. Nevertheless, our results raise a critical point that needs to be evaluated in future studies.

I don't know what has changed to bring up the EP response rate into the 60-70% range since the 52% reported in the Socinski trial that was cited in the presentation. I don't know if that's really something to be worried about or not. EP (w/carboplatin) is still SOC for extensive-stage SCLC is it not? The dosages and cycles are the only variable...right?