ASH2023 - Sheba 2.0, page-117

Now, i know you're looking for something to downramp and be critical on (because that's all you know).
To be clear (because you obviously don't know), RC220 is not a new drug, whatsoever.
It is a new formulation, the pharmacodynamics of bisantrene will not change (There is an infinitesimally small chance of adverse reaction changes, the same reason generic brands must also undergo trials despite extremely minor adjustments).

This is like Paracetamol, woolworths generic brand is to RC110 thqt Panadol is to RC220.
They still do the same thing (pharmacodynamics), slightly different formulations for different brands.

RC220 not acting on the same pathways as RC110 isn't even a risk that registers on my radar.
RC220, from what we know is more likely to have less adverse reactions than the original formulation, but just like any formulation change it has to still be trialled and tested. I still rate that risk as pretty low.