RE: 100x more Dox in Tumor vs Plasma30 Jun 2024 18:35
Thorn, you need to listen to the AGM recording that was posted on twitter.
This is part of an answer CC gave. A transcript does not do justify to the excitement in CC’s voice.
“So, the half life of doxarubicin - straight dox, if we were to dose it, 75mg/m2 is what we give, the half life of standard dose doxarubicin is about 36 hours. So you still have some left in the plasma at that time. We didn't know exactly what the right time was to see that separation. Now, the animals would have told us that it was probably a little bit earlier, probably more like 12 to 24 hours that we would see that distinct separation. However, what we can't do is have a patient sit through, because it usually takes about four hours the first day when they're in the clinic. Then they get their drug, they get the PK samples, and they finally are able to go home about eight hours in. And so let's assume that they got there at 9:00. They're now able to go home around 5:00pm, asking them to come back at 3:00 in the morning for a biopsy it really wasn't in the card. So we asked them to come back the next day, and we take it at 24 hours. Now, we take a plasma sample at the exact same time. So as the biopsy is taken, the plasma sample is taken. And the comparison is the concentration of released active warhead in the biopsy with the concentration of released active warhead in the plasma. The animals would have predicted that we would have tenfold. So, if we had, say, 10 nanograms per ml, we would have had 100 in the tumour, and it was a thousand in the tumour.
I can tell you a funny story. When we first looked at these data with our investigators, and I'm actually going to tell you who it was because he's one of my favourites, his name is Lee Cranmer, and he is at Fred Hutch. He's in California. And he leaned into the Zoom and he looked at me and he said, “Chris, we have vesicant levels of doxarubicin”. Now, vesicant just means it's killing everything in his path. We have vesicant levels of doxarubicin in these tumour biopsies. It was that remarkable. Even to the clinicians who are tired of giving this drug. Now, it's not the perfect time. So if we can convince some patients to come in at 3:00 o’clock in the morning, that is probably the optimal time. But the animals didn't really predict that one for us…..”