General Comments / Chat, page-71

This question was from@EddyG

I always treated/understood MRD to be an indicator of how successful treatment was. Never really found any material to indicate that MRD is focused on separately than cancer being treated. I doubt myself research too much to say that RAC approach is new to MRD, but it appears to be new. At least it sounds to me, like a drug-specific for MRD regardless of the type of cancer. Would be interesting if Dr T / or others, more intelligent people can share their thoughts.

MRD has been recognised as important for a long time in cancer. The problem has been in solid tumour it is hard to measure how much residual disease remains as the small number of cancer cells remaining can’t be sampled. With leukaemias it is easier to measure as the cancer cells are floating around the body in the blood or concentrated in the bone marrow. This makes it much easier to know if there is residual cancer left or not.

The major problem with developing treatments that tackle MRD is you need to use a broad spectrum anti-cancer agents for it to be successful. Almost all the new treatments being developed are narrow spectrum agents targeting specific mutations - as a rule the biotech/pharma industry doesn’t develop broad spectrum anti-cancer drugs anymore. The reasons for this a complex, but it mostly has to do with how the whole industry and regulatory agencies are thinking; broad = old, narrow = new.

Bisantrene is very unusual by modern standards in that it is a broad spectrum anti-cancer drug. If it was discovered today it almost certainly would not get into the clinic - the thinking would be it is just another old fashion anthracycline. Because we have all the historical data we can do clinical trials that would be impossible with a new drug. We have designed the 5 path plan around the strength of Bisantrene to take advantage of its unique properties.