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ESMO poster Probably most of us are a little disappointed that the data reported still only represents the 21 patients reported at ASCO in June. To me it looks like the same data cut from May 2018 taken out to 26 months on the first enrolled patient. The angle that they used to get an accepted abstract is more based on the HLA biomarker. Boiling it down this is really the only new information on the poster: "Clinical responses were seen in patients whose HLAABC RNA (MHC class I) expression is negative to low at baseline; Rodig and colleagues4 have shown that robust MHC class I expression is required for anti-CTLA-4 activity. These data suggest that the combination of tilsotolimod and ipilimumab may overcome resistance mechanisms to anti-CTLA-4 alone, thus enhancing clinical activity and increasing ORR.:" The importance of this finding is that it further defines the patient population. As I have said a number of times previously, with biomarker data IDRA can further hone in on the most likely patients to respond and we should see substantial increases in ORR with improved patient selection over all-comers. These data also represent one more important piece to the microenvironment puzzle and further support the mechanism that IDRA has been touting (improved tumor antigen presentation and tumor "inflamation" cold to hot) for why Tilso shows independent activity above and beyond Ipi alone. We all focus on just the ORR and hitting the 35-40% number but the accumulating translational data goes a long way towards proving beyond doubt how Tilso will benefit these patients. Again the ORR will increase at least in subsetting tumor marker guided patients. This will a vital part of getting the drug approved. |
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