You cannot assume that there has been any changes to the pharmacodynamics of the drug due to an administration route change, particulalrly one that is still bypassing first clearance.
The difference between CVL and PIVC administration routes for clearances are insubstantial.
CVL is delivered straight into a large diameter Superior Vena Cava (Major Freeway) and is then circulated through the body to bind wherever its going to throughout the body and through the bodies clearance pathways (Liver, Kidneys primarily).
A PIVC administration is going from say, the Ante Cubital Fossa and is taking a direct but slightly longer route through main roads (Cephalic/Brachial Veins) to the SVC anyway.
The primary reason for the difference in administration routes is typically due to phlebitis and ultimately venous failure at the administration site, repeated venous punctire will quickly run out of easy access.
If you are suggesting the drug composition has changed significantly enough such that it isn't even going to have the same effect (pharmacodynamics definition), then that too is extremely unlikely.
Even transitioning to an oral formulation, due to Hepatic, Renal or Intestinal clearances it would more likely just require higher concentrations to overcome this first pass clearance.
Pharmacokinetics and Pharmacodynamics are very unlikely effected by RC220.
I do not hold the same concerns as you and i remain extremely optimistic for bisantrene's future, the risk isn't in the science.
*posting on mobile is horrible
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