I too have been doing some thinking along these lines, and really just come up with more questions than answers. But here are my thoughts.
Lu-PSMA is a new treatment. We know it's good, but we are waiting on results from a couple of key trials to have better data on how effective it is. Some preliminary results from one of the trials (TheraP) is here: https://www.anzup.org.au/docview.aspx?id=1233
So this TheraP trial reports a PSA50 RR of 66% with Lu-PSMA alone. (Which is the percentage of patients that have PSA drop of 50% or more. Higher is better).
The LuPin data (interim, sub optimal dose) reports a PSA50 RR with COMBINED Lu-PSMA and Veyonda of 62.5%.
HOWEVER, we are not comparing apples to apples; the PSA testing protocol may be different and LuPin is specifically recruiting patients that are further along in disease progression; the NOX CEO gives a good overview of 3 lines of treatment in a recent video. And PSA is only an indicator, we ultimately want to know about survival, and pain, and safety.
So, to answer your excellent questions @Wealthman91: my guess is that nothing will happen in terms of deals or licensing, because unpicking any effect due to Veyonda will be difficult at this stage. Novartis have their hands full getting LuPSMA out as a monotherapy and new SOC. Also, the continued focus and struggles to get IP protection in place and the hints that their main focus is immuno/checkpoint lead me to believe that no deal is imminent.
But I do hope that we see a RCT of Lu-PSMA vs Veyonda+Lu-PSMA soon.
One big unknown for me and has a big impact on all this, is what timelines and steps are involved in getting Veyonda approved (and for what indication)? Idronoxil is known, but anything to do with the FDA confuses me.
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