Tree of Hope

Some recent research in a specific area has provided some helpful and stimulating findings, which may lead to some unexpected combination trials in the future.

We all know cancer is best beaten with combinations and regimen approaches, but a key question always remains the same no matter which company is doing the R&D – which are the best options to evaluate together given the limited time, resources, and budget available?

Even large pharmas cannot explore every single possibility.

Suppose a company has the luxury of five early stage agents either in-house or available to them in a partnership. This would give 10 potential phase 1 doublets they could evaluate. If we include triplets as an option then we can add a further 60 possibilities on top.

It might sound like a tree of hope, yet these are unrealistic scenarios because few companies will run 70 phase 1 trials just to figure out the optimal regimen to go forward with in a phase 3 study. In fact, I seriously doubt if anyone would seek to attempt this number in mice studies either!

Despite all the misgivings people have about translating preclinical data to humans with advanced cancers, we often need to be reminded to keep our feet on the ground.

It’s not a matter of alchemy where chemists and translational researchers seek the ’elixir of life,” or a pill that would cure all cancers. Instead we have to use some common sense based on what we know and how things might shake out.

In today’s post we look at what some future combinations might look like and who the key players might be…

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