Biotech Values

[ciotera]

Re: CLL induction vs. maintenance

One could do a trial with FCR for six cycles followed by Ibrutinib to progression (switch maintenance), but that's less attractive commercially than Ibrutinib+R for six cycles followed by Ibrutinib for maintenance (which is what we have here). Using R for maintenance is not a good idea in CLL (not oral and doesn't really work).

The future SoC may go either way: turn CLL into a manageable disease like diabetes where you have to take a fairly tolerable (but expensive) pill every day (we practically have that now), or the opposite - cure CLL with a fixed course of multiple active MoAs (e.g., ibrutinib+venetoclax+CD20). Either approach could be a viable value proposition (and they may actually be able to co-exist).