Long-term disease stabilisation ('living with cancer') in this desperate category of patients would be a good outcome, even though not the ideal of partial or complete responses. However, I can't draw much of a conclusion from this, given the lack of a control group dosed only with carboplatin. There are other studies around that seem to indicate that previously unresponsive tumours can subsequently respond to carboplatin after a gap. One study I glanced at had a longer median PFS than 7 months for re-challenging with carboplatin, but I didn't see the detail about what stage the cancers were at - they may have been earlier than Stage 4. Many of these re-challenging studies are focused on patients who've become hypersensitive to carboplatin rather than unresponsive, so it's hard to find comparators, and I don't have the time available to look. But if someone else can give an informed view about whether 7 months PFS for Stage 4 cancers is unusual, I'm interested.
My thoughts are there is enough here to warrant a further look, but no certainty about efficacy at this stage, due to the lack of control group in a Phase 1 study. If the combination radiotherapy trials have promising results, I’d focus the spending on taking those forward instead, as the treatment cycles are much quicker. But if they don’t come through, then the Idronoxil/Carboplatin combo is something to fall back on as a candidate. And it sounds like, from the announcement, the company's current plan is to take it forward.
