Dose finding study is always small. I don't understand why people have difficulty extrapolate from 40mg to 60mg. I understand why from 60mg to 40mg, or from 100mg to 60mg. They didn't do 60mg study by itself, they would have if 40mg deemed ineffective in that dose finding study because next scale up would be 60mg, instead they scaled down to 20mg and found 20mg less effective, then continued with 40mg. They probably would use 40mg for earlier stage CRPC because patients would be on the drug for longer period of time. As I mentioned before, even though they didn't do one study with 60mg, for both RDT and nonRDT trial (they also had more than half of patients in this trial used 40mg sequentially), dose reduction was to 60mg, so they had enough experience with 60mg due to large number of patients with dose reduction. Based on the data I saw in various dose levels, and cabo's long half life, I am finally comfortable with 60mg (40mg for early stage CRPC) they move forward with, even for HCC and RCC.
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