Positive views on Starpharma

With so much negativity on this the SPL forum lately, I thought I would share some of my thoughts regarding the many positive aspects of Starpharma (IMO). Please add your own thoughts below mine.

I am not a blind optimist. I too have been very disappointed with the BOD's track record with the commercialisation of Starpharma's IP. I am part of Antibotter's group and will vote against the remuneration package if we don't get some news that changes my mind in the next few weeks. The thing is, I just cannot help but remain extremely positive about Starpharma's medium and long term prospects because of the extraordinary IP (well protected by patents) and pipeline of products that Starpharma possesses.

First, regarding viraleze:

In the short term, we are potentially just one announcement shy of the whole outlook turning completely around from the current despair that some people have, to possible jubilation! Just think what will happen if /when an announcement comes such as: a partnership with a large-scale manufacturer and distributor in India; a global distributor/partner and registrations in further regions; or a plan for an efficacy clinical trial partnered with a health service, or organisation such BARDA (or even run alone by Starpharma). The first two items have virtually been promised by Starpharma in their announcements and the last item I think is a real possibility.

In the long term, I have the utmost confidence in Viraleze as a fantastic long term product beyond this pandemic. See below for a copy of an earlier post I made about my opinion regarding the long term potential of viraleze: 'Doctors and pharmacists will recommend Viraleze'.

Regarding Viraleze's competition, I see Viraleze as the standout, much better product than current competitor nasal sprays being developed.
Sanotize is a broad spectrum antiviral and antibacterial. It will, quite likely, effectively 'kill' viruses in the nasal passages, which, I believe, will make it effective in reducing the risk of contracting COVID 19 and other viruses. The problem is, I think its much lower selectivity index (higher toxicity) than Viraleze makes it a much less attractive option. Also, one would expect it to also kill the bacterial flora in the nasal passages. It is widely accepted that broad spectrum killing of our 'friendly' bacterial flora anywhere in the body is not a good thing as, invariably, the 'bad boys' - unhelpful or harmful bacteria or fungi - can then take up residence. The nasal passages are no exception. In contrast, I believe SPL7013 may interfere with some bacteria's function - the ability to bind to the respiratory epithelium - just as it does in the case of the vaginal epithelium (I have a theory that this could turn out to be a good thing for preventing secondary bacterial sinusitis following a viral infection, or help with recurrent bacterial sinusitis - see my prior post 'viraleze for sinus infection?') but should not have such a severe impact on the bacterial flora by widespread bacterial killing as a product like Sanotize will.


Viraleze is also looking like a much cheaper option than Sanotize, with less side effects. Consumers are likely to vote with their wallets when choosing an antiviral nasal spray and, I believe, will more likely buy Viraleze. Both Viraleze and Sanotize are likely going to be much, much cheaper than any monoclonal antibody based nasal sprays which may come to market and are both broad spectrum, unlike monoclonal antibodies, thereby remaining effective as the virus continues to mutate and also effective agents in the long term against a wide range of viruses. I think both Viraleze and Sanotize will both be more effective than the seaweed based nasal sprays and much more easily produced at scale (there is only so much seaweed available as a raw product).

Regarding DEP:

Everyone who has read my posts knows my extreme enthusiasm regarding the DEP platform technology and the deep DEP pipeline being developed, especially the three phase 2 trials which are getting very close to being completed. I won't repeat myself here regarding my enthusiasm. I would like to add a few thoughts, however, to counter some negative thoughts that have been offered:

Why has Dr Fairley not bought on-market for quite a long time?

My theory is that it is because she knows too much about the results of the three open-label phase 2 trials and likely cannot buy on-market, without later being accused of insider trading. I would welcome other posters' opinions regarding this.

Will the 3 DEP products currently in phase 2 trials end up competing with each-other for the same indications (as there is a lot of cross-over in the cancers they have been tested against), therefore possibly reducing the monetary value of one, or each of them?

Sarge asked this question some time ago. My opinion is no. I am a GP and have had many of my patients undergo chemotherapy and I have 'travelled the journey' with them. In very general terms (with many variables, such as patient characteristics and cancer type) what generally happens is this: The first line drug is used first (on its own or with another form of cancer therapy such as chemo/radiotherapy) until resistance is encountered. A second chemotherapy drug, if available for that indication, is often then tried until resistance against that drug occurs and then possibly a third drug may be tried, and so on. For example, it is common/standard practice in prostate cancer for docetaxel to be used until docetaxel resistance is encountered, then cabazitaxel is tried. I anticipate the three DEP drugs currently in phase 2 trials, once approved, being used serially in this way to treat a very large range of the most common cancers due to their much improved efficacy and reduced toxicity compared with the original, un-improved versions of the drugs. I expect all three of these DEP drugs to be very effective at inducing durable responses in a wide range of cancers with minimal side effects compared to current chemotherapy drugs.Used sequentially (and possibly in combination), these three DEP drugs (and more DEP drugs to follow, such as DEP gemcitabine) raise the very real prospect of turning many of the most common cancers from short-term horrible diseases, with horrible treatment-related side effects into more chronic diseases (much longer patient lifespan) with much better quality of life (much less side effects). Many of my older / sicker patients are not offered current chemo agents, or they choose not to have them, because they are too weak to endure the expected toxicity and side effects. DEP chemo drugs, with their lower side effects, are more likely to be used in such patients in the future.

So, in summary, compared with the un-improved original drugs, DEP chemo drugs are likely to be used: in a much greater range of cancers; in a much greater number of patients (including being offered to older/sicker patients) and for much longer / many more cycles (the patients should live longer and be able to tolerate many more cycles). The DEP chemo agents are also likely to be offered sequentially (once any resistance is encountered to the first-offered drug) and likely in combination, resulting, in my opinion, in patients living for much, much longer and with much, much less side effects than with current treatments. ie. Changing many cancers from a short / medium term miserable death sentence into more of a chronic illness, with much improved quality of life.

Will DEP chemotherapy drugs become obsolete as immunotherapy drugs 'take over' cancer treatment?

In my opinion NO. Immunotherapy is the 'hot' area of cancer treatment currently but it has a lot of side effects and, if you look at all the studies being done and treatments coming through, you will see that, in almost all cases, it is an add-on therapy to current Standard of Care (SOC) which, in the vast majority of cases, remains: surgery, chemotherapy and radiotherapy. Surgery, chemotherapy and radiotherapy are here to stay for a long while yet. DEP chemo drugs, however (IMO) look extremely likely to become the new standard of care chemotherapy treatments and DEP ADCs and DEP radiopharmaceuticals are very likely to become a new/additional type of standard of care for many cancers in the future.

With recent announcements advising that the three phase 2 DEP trials have had further patients recruited in 2021, does that mean that the results (and therefore deals) are still a long way off?

In my opinion, this means that meaningful results for the most-recently recruited patients may still possibly be a way off but maybe not as far away as we may think if the patients selected have cancers with very poor prognosis. What if all the patients recruited in 2021 have advanced pancreatic cancer? This cancer generally has a very poor prognosis (median OS from diagnosis around 3.5 months with no treatment, increasing to around 8 months with optimal therapy). In pancreatic cancer studies, progression-free survival (PFS) is directly (linearly) mathematically related to median overall survival (mOS) and, therefore, may be measured as a primary outcome in trials (that is, the expected mOS may be predicted from the measured PFS) so shortening the required length of a trial to demonstrate a treatment's efficacy against pancreatic cancer. Remember, Starpharma's customers for the ' 3 amigos' currently in phase 2 trials are Big Pharma. Starpharma's aim is to gather a portfolio of data to present to Big Pharma which results in the highest price to licence the products. In a cancer with a poor prognosis, such as pancreatic cancer, demonstration of impressive interim outcomes (such as tumour shrinkage, reduction in bio-markers and progression-free survival), in my opinion, would be sufficient for a Big Pharma to judge the efficacy of the therapy, without having to go the whole distance of a trial waiting for mOS outcome measures.

Regards to all holders

Gumnut
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PS. To follow, a copy of my previous post 'Doctors and pharmacists will recommend Viraleze'