Serindipity

Professor Nat Lenzo gave a fascinating presentation at the AGM about his experience using intravenous radiation therapy. Nat has treated hundreds of patients over many years, with great success; and used gallium-PSMA PET images to show before and after scans of patients who are still alive today. He noted that Novartis has recently spent over $6 BILLION acquiring companies in this field.

Treatment with 177lutetium-PSMA-617 currently consists of 6 shots, six weeks apart. It appears that in real-world patients who are not chosen for their propensity to respond, one third will typically complete the full course and have a durable response, one-third will relapse and withdraw before the end of treatment; and one-third will not respond at all. Any failure is expensive to the patient, who will die; and to the sponsor, who would have been set to earn over $10,000 for every shot used.

Noxopharm knows that Veyonda is doing something in the body that enhances the effect of radiotherapy and believes that Veyonda could one day be used in conjunction with all forms of radiotherapy, including with early-stage cancer. The company is not allowed to say how things are progressing with the LuPIN trial, but the doubling of numbers (at considerable cost) clearly implies that Veyonda is improving the performance of 177lutetium-PSMA-617. In a serendipitous coincidence, Noxopharm appears to be in the right place at the right time.

An obvious thought is that Novartis might try to buy Noxopharm, but I don’t expect our major shareholder to agree, especially if registration of Veyonda looked reasonably certain.

The disclosure that treatment of sarcoma might be the fastest route to registration has some exciting implications. On 21 march 2018 Noxopharm announced that after six months, a compassionate patient had experienced an abscopal response but (disappointingly for me at the time), her irradiated sarcoma had ‘only’ experienced stable disease. Since then we have been told that the effect of DARRT-type therapy seems to continue over time (hence the 12 week and 24 weeks scans), which makes me wonder whether this lady’s sarcoma has shrunk or disappeared. This is conjecture on my part, but why else would Noxopharm think that sarcoma is a good target?

The advantage of treating sarcoma of course is that as a rare disease, fewer patients would be required for a registration trial. The prostate cancer registration trial is still scheduled to commence in 2019 but its design cannot be finalised until the results from DARRT-1 are known.

We are looking good, in my opinion.0