RE: RNS11 Aug 2021 22:04
@Kong1
Currently the use of dox is curtailed due to side-effects e.g. chronic heart failure and is given at the same doses, where total cumulative doses of doxorubicin give rise to excess of 450 mg/m² in the heart tissue. This usually limits the number of chemo rounds to approx 6.
Avacta pro-dox, is starting on a 3+3 dose escalation open-label study, and my view will be that dosing will escalate (approx.) 80mg/m², 133mg/m², 200mg/m², 280mg/m² and 370mg/m² per round. We have pre-clinical data that shows that AVA6000 gave an 18-fold more active substance in the tumour versus the heart. The # patients will incrementally increase in number per round: 3, 6, 9, 12, 15, 18, 20(/21).
Once AVA6000 has reached round 3 (i.e. 9 patients), the first cohort of 3 patients will have received close to 450 mg/m². This will get quite interesting, because beyond this point we will have a clear indication of any issues from the first cohort of 3 patients.
I believe that Avacta will have received notice of the first patient dosed late last week, however, the actually date of dosing can be a week or two before. Which puts us around mid-late July when the actual first dose was administered. From my understanding, the fourth round will be around late September to mid-October. If we hear no news about AVA6000 before October 15th, then this becomes positive news i.e. the more days that go by without mention of toxicity the better (note that trials can be stopped early).
AVA6000 has an 18-fold more active chemotherapy in the tumour then the heart (pre-clinical data). Currently patients have a prognosis of 12.8 months without chemo and approximately 14.3 months with. I believe this increase in dose available to the patients will dramatically improve the survival of patients.
Alastair mentioned in the last presentation that we are waiting on the initial pharmacokinetic data, in simple terms the distribution of the drug around the body. It will be a significant milestone for the group as a whole i.e. a big re-rate for the company. My calculations, suggest that this data will be available approx. 12 weeks from now and as such I am expecting it before the end of the year.
At rounds 4, 5, 6 and 7, the total cumulative dose of pro-dox will be well in excess of the 450 mg/m² which implies that data by the end of the trial along with informing stated primary and secondary outcomes, will intrinsically provide the therapeutic effect of AVA6000 in a small cohort. Which in itself will be additional good news.
To summarise, from here on in, no news is good news and as time progresses the more positive it is. By end of October we could well have the data for analysis, and would certainly have some tope line read out by the end of the year. PK data will be sufficient for a rerate.
1/2