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Sunday, June 21, 2020 6:17:26 PM
Many years ago I attended a pancreatic cancer meeting as I had a stock that had a drug they'd be discussing. I had the pleasure of eating with a person who'd been fighting the disease for over 5 years without the whipple procedure. His philosophy was interesting, essentially he'd find an oncologist who believed they could benefit him, when the cancer reared it's ugly head again and the oncologist indicated he knew of nothing more he could do, he'd thank him, and find a new oncologist. He had been through several oncologists, but to look at him he didn't appear sick, though clearly he was. I hope he's still finding oncologists.
I'm a big believer in varying treatments so the cancer doesn't become refractory to what you're hitting it with. Decades ago IMGN had drugs they gave up on, patients became refractory to them quickly, though they were effective for a short while. Perhaps the biggest benefit of the drug was that after taking it, patients were found to not be refractory to the SOC drugs that they'd previously become refractory to. I don't know that life couldn't have been extended indefinitely with using the SOC until you become refractory, than a brief time on IMGN's drug, then back to the SOC.
It would be very awkward to try to gain approval of a drug that worked in that manner, yet it might extend life dramatically. What's unknown is how many times you could repeat the same scenario, and if the duration with the SOC was diminished with each cycle, but if it weren't, patients could potentially live a long life just alternating drugs to avoid becoming refractory to either.
Gary
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