If what Richard is saying is verified with the 7 remaining patients currently on study, who were selected based on the additional criterion of their ALC having to be above 900, if the response rate in patients with ALC > 900 is about 80%, and the CRs rate is 40%, which also indicated that SD/PR patients have a chance of converting into CRs on treatment for refractory PTCL, then yeah, CPI-818 might very well be competitive with CHOP in the frontline setting as well. CHOP is brutal on your immune system. If you have a normal ALC level (around 4000), I would opt to take CPI-818 first, especially if you’re positive for Th2/GATA3, which has poor prognosis for survival, and the hypothesized mechanism of action of CPI-818 seems to be blocking Th2 and Th17 and skewing toward Th1. After refractory PTCL, maybe the fastest path to frontline PTCL is through subset of patients with positive Th2/GATA3. And then position CPI-818 as second line behind CHOP for patients who progress or become lymphopenic (ALC level dropping below 1000). And then do the CPI-818/CHOP combo for all front line study.
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