Thanks for the clarification, Peter. I would have thought that maybe a combo of Tarceva with AP26113 would be appropriate, and that question was asked by an analyst. Specifically, the analyst wanted to know why these drugs are being tested sequentially rather than in conjunction. Dr. Shaw answered that the problem was toxicity.
Do you expect a head-to-head trial with Tarceva, eventually?
Dr. Shaw mentioned that resistance to Crizotinib was showing up 10-12 months after starting treatment with Crizotinib. She said that there was a critical need for a second-line therapy. I have a couple of questions about this: Do the Crizotinib-resistant mutations confer a more virulent profile for the disease than the pre-treated disease? If--as Dr, Moro said about Imatinib-resistant disease--that Crizotinib-resistant disease is a vastly different disease than the pre-treated lung cancers, then why didn't Dr. Shaw mention anything about AP23116 as a potent first-line therapy? I assume this would, eventually, require a head-to-head study with Crizotinib.
What exactly are your thoughts on Dr. Moro's rather vociferous criticism of those community oncologists and hematologists who would refuse to consider Ponatinib as a first-line therapy in CML? (I was a bit stunned by Dr. Moro's presentation of arguments that were so forcefully critical of colleagues in the field. Surely, this will be a lively, ongoing debate in the field. I have forwarded Dr. Moro's comments to my personal hematologist, since he is one of the hematologists that Moro was addressing. My hematologist is a really good guy, who would be considered a "pure clinician." I once asked him who he takes his cues from in developing his treatment regimens and he said, without any hesitation, that it was Dr. Cortes. But when I forwarded him Cortes' article on using Ponatinib in first-line CML, he maintained his position that he wouldn't use Ponatinib that way. I'll be interested to what he has to say after listening to Moro's remarks.)
Bladerunner
P.S. Were you at all surprised by ARIA's aggressive attempt to move into front-line therapy in CML? Your earlier posts implied that you didn't think ARIA would move in that direction very quickly. Dr. Haluska seemed to indicate that ARIA has been planning for a head-to-head trial in first-line for some time. There were a number of nice tidbits like this in the presentation that proved to be good fodder for the analysts, not to mention ARIA longs.
AI
