I await some serious statistical analysis of the data presented in 2 weeks time. Some initial thoughts.
A) 8 months PFS in the liver is a fantastic result, especially considering the advances made over the past 10 years in the treatment of mCRC. It will be interesting to see (if we get that level of detail) how the statisticians dealt with a constantly moving target on the control arm during this period.
B) we know from the recent report (see previous HC thread) that the technology for determining those best suited to SIRT has improved in leaps and bounds over the past 10 years. So it would be most interesting if they slice and dice the data to show if the benefit is greater for the more recent data sets, as opposed to those in the early stages.
C) it would also be useful to know if individual centers had an increasing upward curve in results due to being more experienced in the procedure. This would be a double edged sword, but internally it would allow SRX to refine the procedure for a more uniform delivery. We know that a new delivery set was being trialed about a year ago, but we have no data recently.
D) PFS/OPFS/OS - this one is of great interest, as it really is the bottom line for a difference between being mandated and a long hard marketing slog. We have 8 months PFS, but almost zero on OPFS. Clearly this tells us that other organs are not being controlled with the standard of care.
Because the liver mets generally are the killer up until now, it has been a case of stalling the other mets as much as possible as the liver mets will often kill the patient. Now that the liver mets can be controlled for an extra 8 months there will be much more focus on the other organs. It is the critical path problem, which for those who have ever managed large projects is the bane of one's life.
The question is, does the extra 8 months yield an OS result? And if so, then by how much?
This may be too simplistic, but here goes;
i) if the other organ mets can't be controlled more than current practice, and their ability to kill the patient is only a few days / weeks behind what would have occurred by the mCRC anyway, then there could be zero or low OS.
ii) if the other organ mets can't be controlled more than current practice, but their ability to kill the patient is many months behind what would have occurred by the mCRC, then OS will also be many months improvement.
iii) If other organ mets can be better controlled, along with the extra 8 months from SIRT, then we are almost in the bag for an OS result.
I think that the lungs and breast are the next in line organs, once liver can be controlled a little more.
If anyone could assist with the average OS of each of these cancers it would be helpful, as it would point to the chances of OS being good or not.
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