Continuation of excellent posts by Sdraw on YMB

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biopearl
Posts: 367
Joined: Wed Dec 09, 2015 12:12 am

Continuation of excellent posts by Sdraw on YMB

Post by biopearl » Fri Mar 23, 2018 5:54 pm

Reposted from ymb, Sdraw deconstructs arguments made by presumed short :

sdrawkcabeman23 minutes ago
(1 of 4 posts)
Whyted, thanks for commuting my post to Alpha Exposure(AE). Unfortunately, reading AE’s response, I see he still hasn’t grasped the absurdity of what he wrote.

He said, “You seem to agree that the IMbark trial enrolled patients who - on average - were healthier than studied in the BLOOD paper. Since that's the case, shouldn't they be living longer than the people followed in the BLOOD paper?”

AE, I don’t seem to agree with ANYTHING you said. You’re completely, wantonly, factually wrong. In fact, thanks to your “article” I can actually show you why Imbark median OS is even stronger than in the Blood paper. We can even see the impetus for frontline Imet. So I’ll deconstruct the Blood paper, and then put a sword to AE’s absurd “article” once and for all.

The MD Anderson study(MD study) was a review on Rux discontinuation based on a P1/2. Take note, the original P1/2 excluded pts with <100K/uL platelet counts, while Imbark excludes <75K/uL. It’s an acknowledgment that Imbark R/R pts are sicker.

Of the original study of N=107, only 56 were assessable for follow-up; of these:

“At the time of discontinuation, 6 (11%) patients had transformation to AML, 37 (66%) had progressive disease, and 13 (23%) had stable disease.”

Did you get that, AE? Hats off to Hoosier for pointing out Imbark’s inclusion criterion of disease progression. The OS for the MD study was actually skewed longer b/c they included 23% pts who had STABLE DISEASE, whereas 100% Imbark pts have DISEASE PROGRESSION. It means Imbark’s median OS is even more substantial since more pts are sicker(more on the <75K/uL exclusion later). And Imbark has 2-3x more pts than the MD study.

And let’s not ignore this part, “Treatments received after ruxolitinib discontinuation included hydroxyurea (n = 15), investigational agents (n = 13), splenectomy (n = 9), ASCT (n = 7), hypomethylating agents (n = 6), induction chemotherapy (n = 3), and anagrelide (n = 1).”

Investigational agents can skew OS significantly. N=13 could be 13 different drugs/combos. The uneven investigational nature adds uncertainty to the MD study’s 14 month median OS as a comparator, unless it were a true head to head with those investigational agents.

Upon discontinuation, Rux pts were more transfusion dependent, with “significantly more” abnormal cytogenetics, intimating clonal selection. If Rux pushes pts to AML, it’d be a serious case for Imet as frontline. They also cite Rux discontinuation at 50% at 3yrs in Comfort I/II.

The MD study concludes, “Our findings underscore the need for novel therapies for MF that is relapsed/refractory... support for the prognostic relevance of mutations... earlier intervention with... investigational targeted therapies should be explored in patients treated with ruxolitinib showing signs of disease progression.” Imet fits that novel therapy description perfectly.

biopearl
Posts: 367
Joined: Wed Dec 09, 2015 12:12 am

Re: Continuation of excellent posts by Sdraw on YMB

Post by biopearl » Fri Mar 23, 2018 6:40 pm

Here is a link to the rest of Sdraw's recent posts. Very worthwhile reading. bp


Fishermangents
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Re: Continuation of excellent posts by Sdraw on YMB

Post by Fishermangents » Fri Mar 23, 2018 11:31 pm

Yes, it does!

jpheis
Posts: 24
Joined: Thu Jul 27, 2017 2:55 pm

Re: Continuation of excellent posts by Sdraw on YMB

Post by jpheis » Sat Mar 24, 2018 1:17 pm

Sdraw is top shelf. He has all the attributes of a Chief Medical Officer with a clear passion for Imetelstat. We should re-post all of his writings into a thread here.

biopearl
Posts: 367
Joined: Wed Dec 09, 2015 12:12 am

Re: Continuation of excellent posts by Sdraw on YMB

Post by biopearl » Sat Mar 24, 2018 3:37 pm

jpheis, Great Idea (I just have to learn how--will consult with Fish) bp

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