>> the toxicity from the long-term use of anti-angiogenic agents is an important issue… Squalamine and Combretastatin [CA4P] will certainly show some kind of side-effects in the long-term (these 2 drugs target neovessels, you generate neovessels not only when you have AMD but also when you cut your finger)… <<
Isn’t this a matter of degree? You appear to be discounting the very short circulating half-life of CA4P and Squalamine. CA4P’s plasma half-life is less than 4 hours. (Source: OXGN’s Rodman & Renchaw webcast [5 minutes from start]: http://www.wallstreetwebcasting.com/webcast/rrshq/oxgn/ )
With such a short systemic duration, one might expect the problems arising from systemic administration to be small, even if treatment needs to be repeated on a regular basis for months or years.
(Nevertheless, one would not want to incur even a small risk without a commensurate benefit; for this reason, I think it’s unlikely that these drugs in their current forms will be used prophylactically to avert AMD in high-risk patients.)
>> …4 months data is very small. <<
isolution, as you probably know, both Squalamine and CA4P have been studied for much longer periods than four months in cancer trials without serious adverse events. Moreover, both drugs have a clean safety record in lengthy preclinical studies.
>> That is why I think any drug shall be studied with an adapted drug delivery device to limit potential side-effects, even if they are unknown today… The systemic administration of these drugs is not the ideal way of treating ocular angiogenesis, as the drug does not reach the target tissues at an optimal concentration... That is certainly why Oxigene insists on their last PR about local administration of Combretastatin ...and Geneara should be advised to think about a way to deliver Squalamine locally. <<
Agree. However, neither company can afford to drop development of their IV formulation while waiting for something better. There is no guarantee that a safe and effective local-delivery mechanism is attainable. So, yes, these companies should attempt to develop a local-delivery mechanism, but this work should proceed in parallel with the rest of the clinical program.