The decision to test Veyonda dosages at higher levels in DARRT-2...

The decision to test Veyonda dosages at higher levels in DARRT-2 was perplexing at first glance, until I considered Noxopharm's strategy as a whole.

The IONIC trial will give NOX an early opportunity to see whether Veyonda boosts the performance of Opdivo, with efficacy scans likely to be conducted after just two months. If results are good, BMS will want to lock up Veyonda as a matter of urgency.

But it might not be available! It is clear that Veyonda significantly improves the performance of Novartis-owned Lutetium-PSMA, which has yet to report results from its pivotal Phase III trial, so it would not surprise if Novartis also wanted to lock up Veyonda in order to market both drugs as a package.

And what about Merck? Would it be happy to see the combination of Opdivo and Veyonda take billions of dollars in market share from Keytruda? It would not surprise me if one of these companies licenced Veyonda in 2021.

NOX will not sit still waiting for the kettle to boil. A partnership would immediately remove financial restrictions, but in the meantime Noxopharm is clearly making its cash go further. Government approval of an R&D rebate for overseas expenditure was a real coup.

IONIC will be a cheap trial with massive implications, NOXCOVID is percolating away, STING-related opportunities are being explored, and DARRT has been modified so that the main expenditure does not occur until IONIC responses are known.

DARRT-2 will involve repeat doses of Veyonda at twice the levels previously used, with a small dose-escalation phase testing this regime against a number of cancer types, to see whether a high proportion of abscopal responses can be routinely generated.

Results from the first part of DARRT-2 should be known to Noxopharm at about the same time it learns of IONIC responses and Lutetium-PSMA survival data. If results are good, GK will be well placed to execute a profitable deal.