You can’t make this stuff up…

[biopearl123]

From Steensma:

“ Of the 8-week RBC TI responders, 62% in the overall population and 75% in the subset population had a hemoglobin rise of 3 g/dL or greater from the pretreatment level. The 8-week RBC TI rate did not differ on the basis of baseline RBC transfusion burden, presence of RS, or baseline sEPO levels (Fig 1).

You just can’t make this stuff up! And its pretty pretty unlikely to happen all by itself…

[rccola335]

this is from the Journal of Clinical Oncology January 2021?

[biopearl123]

Yes IMerge PII.

[rccola335]

you might want to choose a different title - read that and figured it was bad news - i suggest one like "makes me smile when I read this" or maybe "this never gets old"

[biopearl123]

Nope, I like this one. You can post under a different title if you wish. From the moment I saw the BM slides from Dr. Tefferi’s original study that showed clear PRs and CRs in a disease where that doesn’t happen very often I said the same thing. “You can’t make this stuff up”. I briefly entertained the thought that some malicious person in the chain of command was switching slides, but it was the Mayo Clinic after all and many high quality people albeit from the same institution were involved in the study so that seemed unlikely, not to mention vetting by the NEJM. But then the Janssen study showed no CRs or PRs (but did show improvement in fibrosis but not to the point of PR) so I remained perplexed and could only speculate it was due to the very advanced stages of disease in the latter. I stand by my title of the post you reference. Best Wishes, bp

[LWS]

From biopearl123--- But then the Janssen study showed no CRs or PRs so I remained perplexed and could only speculate it was due to the very advanced stages of disease in the latter. I stand by my title of the post you reference.

This is the critical point. Cancer, in any form, has a greater chance of positive treatment when treated early. Cancers in advanced stages are generally not treatable. Earliest possible use of Imetelstat seems to be commonsense, especially considering Mayo Clinic's earlier results.

[biopearl123]

It’s not that straightforward. Once therapy begins, the “easier” to treat clonal manifestations may diminish while more resistant clones (clonal selection or clonal “drift”) may emerge and dominate; making later treatment much more difficult. This of course is why the finding of life extension and disease modification is so extraordinary. It also presents the obvious problem of when exactly does one start treatment with the inevitable emergence of resistant clones and more complex mutations yet to come as the disease progresses in the majority of cases. Remember the MRD (minimal residual disease discussions?) Board members, if I don’t have this right (as a non oncologist), please feel free to correct. bp