Excellent KOL presentation

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biopearl123
Posts: 349
Joined: Fri Jul 20, 2018 5:13 pm

Excellent KOL presentation

Post by biopearl123 » Thu Jun 18, 2020 6:49 am

If you haven't tuned into the KOL :
https://event.on24.com/eventRegistratio ... e=register

Don't miss it. It is excellent. New therapies need a champion and Geron has identified them. They all spoke well with very professional world class academic presentations. I just want to mention a few things. Dr. Mascarenhas was gentleman about it, but the longevity study, showing not only longevity but on target drug/molecular/clonal effect but was slighted by not receiving the recognition conferred by the honor of an oral presentation. One thing that I and others have discussed previously over the past few years was the high drop out rates (see prior posts discussion re something like how can a caterpillar know it will turn into a butterfly). The issue in prior posts related to patient retention in a study that was apparently not meeting its primary end point particularly that of spleen reduction. We now know that the end points that caused Janssen to walk were actually achieved in several of the patients who showed on target response but also that spleen reduction even of 10 % can be meaningful (discussed in prior posts). We also know that MOS is the one ring to rule them all and Janssen missed the mark in recognition of the importance and that the spleen/sx end points were JAK centric not Imet pertinent. We also know that Dr. Mascarenhas gave more than passing thought to the idea that the low dose MF group WAS in a sense a control as we have discussed before and probably also showed improved MOS if compared to no drug (speculation). But what I took to be most important in explaining significant MOS improvement in the face of a high drop out rate was the passing reference to the fact that suppression of the malignant clone and alteration in the natural history of the disease can still occur long after the drug has been discontinued. There was speculation as to whether regimens such as Imetelstat first then JAK inhibitor RX or some combination could be tailored to the patient depending on the course of the disease. Its worth repeating, Imetelstat effect on longevity and presumably the malignant clone can continue for a substantial period after the drug has been discontinued for adverse effect or other reasons ( perceived failure to affect spleen etc.)--patients may be motivated to stay on drug for effects they can not see--e.g. longevity. This is why the study is designed the way it is. The first peek will be pretty early at the 70% of 50% mark or when about patient deaths are in the high 30% range. Other thoughts, we will hear more about MDS with bone marrow fibrosis (no effective treatment to date). Other points have been discussed previously but the potential to reduce blood transfusion and reach sustained TI has never been achieved like the results described to date before. Anemia has not been discussed too much in the MF patients but this will also probably be impacted as well as the extraordinary sustained reductions in TR described for the MDS patients. Kudos all around. To quote a famous physician, its a game changer. What saddens me it that other indications like AML and high risk patients will be denied a chance to get this drug for the foreseeable future. Please share your thoughts, bp

biopearl123
Posts: 349
Joined: Fri Jul 20, 2018 5:13 pm

Re: Excellent KOL presentation

Post by biopearl123 » Thu Jun 18, 2020 9:26 pm

As the information from the EHA and KOL percolates into the financial sector, it is pretty clear that Geron's Imetelstat occupies its own space with no significant competition in the high transfusion requirement, low risk MDS sector and the MF sector re significant life extension. The physician champions that presented at EHA and the KOL meeting have made an unequivocal case for a drug the meets current unmet medical needs. Further and faster development (high risk MDS, AML) could be advanced by a forward looking, proper fit partner. Let's hope one will materialize. This drug would be through PIII in MDS and nearing end of PIII in MF if Janssen had not vaporized with valuable time lost as the required hoops were jumped through with the return of the drug to Geron. We as investors will probably be better off for this but I don't think the patients are well served by these types of delays. bp

bucbeard
Posts: 37
Joined: Wed Jul 25, 2018 12:30 am

Re: Excellent KOL presentation

Post by bucbeard » Thu Jun 18, 2020 11:03 pm

This is first class assessment BP. As always, thank you for your very valuable insight on all things Geron/Imetelstat!

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