1/n I'm looking at $LPTX right now and trying to understand the stock price drop following #ESMO22.
There is actually little change in the data compared to previous ASCO-GI 2022 data.
If you do a more rigorous evaluation on an ITT basis and count only confirmed responses,
2/n the ORR is 52% and is not much greater than the ORR of nivo + chemo (47%) or tisle + chemo (47%). However, the mPFS is significantly greater (11.3 mo vs 7.7 mo and 6.1 mo, resp.). mOS has not been reached after a median study duration of 15.7 mo (nivo + chemo mOS =13.8 mo).
3/n Subgroup analysis is too complicated for a Twitter posting because of different, sometimes opposing influences, but does not change the summary.
Perhaps it irritated the investors that mPFS of DKK-high group (11.3 mo) is smaller than the mPFS of the DKK-low group (12.0 mo).
4/n I am not really irritated by this so far, because
▪ in the DKK-high group 1 patient was n.e. (scored as PD)
▪ DKK-high is usually associated with a worse prognosis
▪ DKK-high patients had 42% liver involvement, DKK-low only 11%)
5/n ▪ some of DKK-high patients had larger tumor diameters at baseline,
etc.
Subgroup analysis is, as I said, quite complicated, especially with such small collectives.
6/n Conclusion: I cannot find a convincing explanation for the $LPTX share price development following #ESMO22.
If anyone has something illuminating to contribute to this topic, I would be pleased.
7/n Perhaps I should add: This is about therapy with the anti-DKK1 mAb DKN01 + tislelizumab + chemo in the indication 1L GEA. The value of $LPTX currently depends substantially on the outcome of this indication.
8/n $BGNE should have the results of the Rationale 305 trial by now (tisle + chemo vs chemo in 1L GEA). The comparison of these data with the results of the DKN01 + isle + chemo combo will certainly determine whether $BGNE will take the Asia option for DKN01 or buy $LPTX.
9/n I'll finish looking tomorrow to see if there were any particularly good results in 1L GEA in any competitor study presented at #ESMO22.
$LPTX
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▪ ZW49 $ZYME seems well tolerated, however, unexpected is the alopecia (→ the linker would need a closer look).
▪ The dose needs to be increased (T-DXd is dosed much higher).
▪ The efficacy data (ORR, DCR) at 2.5 mg/kg 3QW in ≥ 3L mBC are very weak,
2/n
but those in ≥ 2L GEA are surprisingly about as good as T-DXd at 6.4 mg/kg 3QW.
▪After 3 years of phase 1, the overall data situation is very thin.
3/n
After reading through the transcript of the CC, I cannot understand the $ZYME Mgtm's rationale for moving ZW49 forward.
For example, in the 3L mBC indication, 1.5 mg/kg 3QW ARX788 $AMAM achieves 66% ORR and 5.4 mg/kg T-DXd $AZN achieves 61% (median 6 pretreatments in each