Replies to post #17205 on Biotech Values

[DewDiligence]

>until we have new data, the rational sequencing strategy is 1) FOLFIRI plus bevacizumab; 2) FOLFOX; 3) irinotecan plus cetuximab<

Saltz thinks your sequence has roughly equal merit with: 1) FOLFOX+Bev; 2) Irinotecan mono or FOLFIRI; 3) Irinotecan+Cet. In other words, Saltz is essentially neutral on the Oxaliplatin vs Irinotecan issue, considering it a wash after taking into account the differences in efficacy and toxicity.

Saltz feels strongly that multiple lines of Bev are not warranted based on exiting data. Also, he is inclined to use Irinotecan+Cet in the second line after FOLFOX in the first line when such use is reimbursable, but it generally isn’t because Cet is off-label in this scheme.

>I have not been following panitumumab, I consider it a me-too and not worthy of the attention it is getting.<

Agree that Pani is not too interesting from a medical standpoint, but it is very interesting from a signal-reading and handicapping standpoint.

[terry hallinan]

rfj1862, Dew;

Thank you both for an excellent and informative exchange.

I did not catch Saltz's ASCO talk

I did only since Dew provided an old post with a link.

There is something in Dr. Saltz's talk that is very discouraging to me. He says maybe it's the diet that causes differences in tolerance of the drugs between Americans and Europeans. Could be, of course, as well as even differences in recording side effects.

But Europeans aren't Americans as a group and each within the group have individually different genetic heritage.

Personalized medicine obviously has a tough uphill climb when even a renowned doctor like Saltz makes so little concession to genetics.

JMO.

Best, Terry