I have also given this some thought. The SOC for first line NSCLC is paclitaxel and Carboplatin. Doxy is perhaps a somewhat superior derivative of these Taxenes. Since you don't get to 2nd line without failing first line, why not use a different chemo combo and again Doxy is SOC in 2nd line so you get a direct comparison. Remember, ORR in 2nd line with Doxy is only 6-9% area.
The "real magic" in this is that all the chemos seem to act in the same way. They are anti-mitotic, i.e they inhibit rapid cancerous cell fission and in so doing are somewhat apoptotic. The fact that a patient fails chemo should in no way impact the MOA of Bavi which is to target PS on the cell surface and to upregulate immuno response and inhibit blood supply as opposed to the anti-mitotic MOA of chemo. In fact, even though you are a patient that has failed chemo that same chemo should have increased PS on the cell surface and make Bavi more effective.
THIS IS PRECISELY WHY THORPE HAS BEEN SO BRILLIANT IN UNDERSTANDING THE MOA. It makes the case to the FDA for an alternate MOA--a totally different approach and hopefully a synergistic one. This is so brilliant in fact that I am not just thinking about PPHM as an investment but really hoping for the success of this trial as AA for all the patients who really need it so they can get into it as quickly as possible..
IMO high probability that Bavi will far surpass the 6-9% hurdle and by that I mean by way more than the statistically signifigant 10%.
All in just my opinion.
Best Regards,
RRdog
