ImetelChat

So, a few hours ago, Taz posted on YMB that Mesa might have come around to treating/advocating/investigating Imetelstat for MDS due to Mayo Scottsdale being newly added to CT...And, someone else further posted that that would be significant as Mesa was negative towards Imetelstat previously...what's the history there?

...BP...you seem to know your Geron history...what's the scoop?

There was a time that Tefferi was a bit explicitly ventilating in public that Jakafi was only palliative and that he was looking for a drug that really takes away the disease. He did that in a period that Jakafi was just approved and everybody was a kind of hyping about the drug. Tefferi is very straight, has a scientific take on his profession and also is a strong character. He didn't like this hyping (and pricing!) as it may raise too high expectations with the patients. He also suggested that mainly the industry benefited from this drug. Mesa may be a little more active towards the patients community and took a more neutral approach because probably he was happy enough that these very sick patients had at least something that improved their quality of live. To my knowledge he never stated something negative about Tefferi or imetelstat in public. Although he may have felt challenged by Tefferi once in a while, he always stayed professional. Until recently, he didn't say much about imetelstat in his presentations. But neither did Verstovsek or others, because it was just too early. And with a new MOA you probably will wait even longer. As a doctor you must be very careful with speaking about new drugs under development in order not to raise any wrong expectations. In addition, as a Mayo colleague of Tefferi he probably had to be even more careful as he certainly may have known more than others. That has now changed, becasue most leading doctors now do speak about imetelstat (just see the latest video of Verstovsek!), so does Mesa. That is a good sign, because that means that there is sufficient confidence about imetelstat's safety and efficacy. I don't believe there is a personal issue involved here. Mesa is a very straight and honest person, who's mission clearly is to help patients. So is Tefferi.

Thanks for the your in depth response!

Bio, I just saw that scott was addressing this question to you...I shot of bit quick. Sorry. Nevertheless I would be interested to hear your opinion on this.

Scotty, have been away for the last week and just catching up now. Saw your question. Fish gave a very nice response (better than mine would have been!). My take is that site selection is not physician dependent. Little doubt that Dr. T had a lot to do with site selection and by doing so giving votes of confidence to his colleagues, including Dr. Mesa in this ground breaking study that will almost certainly lead to approval if findings confirm pilot study. Re hoosier speculation that data will be presented at ASCO: no. (IMHO). I think Dr. T will use ASCO to set the table for ASH when we might get a glimpse of the data but until there is some statistically meaningful data I don't think we will hear about the Janssen MF dosing study other than a large advertisement that it is ongoing with a review of the protocol and a plea for physicians to enroll patients in the study. ASCO seems to be a solid tumor conference more than ASH which concentrates on liquid tumors. I was hoping we might hear from the Pediatric consortium at ASCO (a late breaker?) but maybe not. I do think Dr. T will update the pilot study and maybe the other later enrollees (which we never heard too much about) in the Mayo single site study, at ASCO. Its really about time for a statement on effects on longevity and potential to alter natural history of this devastating disease. Best regards to all and thanks to Fish for running a first class board. bp