I've also been trying to get my head around how with TLX591 OS ois so markedly better without seeing large immediate reductions in PSA and how that might relate to PFS.
Is it that that cells being exposed to longer doses of lower radiation levels which aren't killed suffer damage which result in them being unable to replicate?
So the superior specificity and targeting of the antibody allows more essentially healthy prostate tissue to survive. Seeing as healthy cells also produce PSA;we see a lower initial PSA drop but a slow reduction over time as those essentially healthy cells die with out replacement.
Of course the conditions that led to the cellular damage that lead to cancer still exist so eventually we see progression É“ut at a much slower rate because replication is impeded.
I think when a non cancerous cell encounters problems with replication, apoptosis is induced so the cell essentially commits suicide. Not so with cancer cells. (Please excuse my vague recollection of high school biology)
So I guess if any of this holds true then PFS can be improved by a smaller margin than we might expect and still see massive improvement in OS because the progression rate is far from linear.
So even though the patient has progressed; it's a 'pseudo progression'.
The scientists amongst us are probably laughing at my assumptions reading that
Anyway I'm no expert on the prostate glsnd but I've done a lot of wanking so I guess I'm somewhat qualified
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