Biotech Values

[iwfal]

(Mutations that are more prevalent in cancer have a *long* history of NOT being very predictive of being a good target.)


Can you elaborate on this? I'm not sure I understand you here.

Sure. I am commenting a little tangentially. Gottlieb's FDA is implying that there are some genetic signatures that, when directly targetted, provide high probability of an efficacious treatment regardless of tissue of origin.

My comment was that there is *some*truth to this for random mutations, but only some. Just because a Kinase Inhibitor X works in tissue-of-origin Y, doesn't mean it will work well in other tissues with the same kinase mutations. So, before you can harvest this trial efficiency you first have to prove tissue agnosticism - which probably negates the benefits.

BUT - the one area for which there there is a lot of data to indicate tissue agnosticism is kinase fusions (and other fusions?). Kinase fusions, for reasons that don't appear to be completely clear to anyone, have a much higher hit rate. They are much more likely to be disease drivers than just general upregulation or mutations. LOXO has, if I remember correctly, explicitly commented on this. Of course it isn't perfect (ALK inhibitors in CRC seem to have whiffed?), but still there is probably a lot of trial efficiency to be mined there.