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You also have to keep in mind that acquired resistance rates for immunotherapy are higher than efficacy. Acquired resistance is where patients initially responded to treatment, however, over time, their cancer has stopped responding.

Using the information from the summary table below:
- Average ORR = 34.4%
- Average Acquired Resistance = 38.6%

Bisantrene has been shown to sensitize an aggressive, resistant melanoma mouse model to anti-PD1 therapy. Given immunotherapy also has cardiotoxicity issues, Bisantrene sure does seem like an excellent candidate to pair with immunotherapy. This is further evidenced by patients who have received 7-8 grams of Bisantrene without cumulative toxicities. Pairing another drug with immunotherpy that also has cumulative toxicities is just a ticking time bomb. I think I am starting to really appreciate the role Bisantrene can play clinically - the ultimate sensitizing agent.