That is an undervalued point most investors do not make the connection on. Medically proficient contributors have pointed it out but most investors tend to stick to the 3 phases after a drug is developed: 1) safety 2) efficacy 3) peer comparison.
If a drug is deemed first in class and shows survival benefits, it will be essential to bring to market sooner than later. The amount of lives lost between a P2 and P3 trial does not warrant a peer comparison if it already displays improved results over its peers.
In the case of Imetelstat, there is no equivalent peer
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