Re: HCV cocktails
>because there will be cross-resistance to drugs of the same class…<
This is not necessarily true. Moreover, second-line cocktails can contain a class substitution without having to resort to ifn.
>there has so far been significant toxicity with the oral agents.<
You’re painting with too broad a brush. Toxicity of these agents has been dose-dependent and the oral agents currently in development are efficacious at much, much lower doses than the prior generation.
>…you think doctors and patients are going to randomly mix and match various direct antivirals<
They will mix them, yes, but it won’t be random. The mixing will be based on an understanding of the individual drugs, just as it has been for HIV cocktails.
>…interferon and ribavirin will represent novel MOA agents for second line if supplanted as first line<
You seem to be assuming that ribavirin won’t be used in the first line. I’m not making any such assumption; to the contrary, I think there’s a decent chance that ribavirin will be used in a first-line non-ifn cocktail.
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