关于 intismeran 在 #ESMO26 的报告 $MRNA $MRK
我对哥本哈根大学的 Inge Marie Svane 所发表的讨论报告的印象是：她对 INTerpath-001 持积极态度，即便算不上过度热情。
“审慎”或许是最佳的单一形容词。
“残酷”是现场一位投资者向我形容她演讲语气时用的词。（他做空 Moderna，所以也得考虑这一点。）我不同意。“残酷”太苛刻了。如果人们原本期待 Svane 欣喜若狂，那么没错，她确实没有达到这一期待。在我看来，她的表述大体上是不偏不倚的。
她没有在 mRNA 疫苗与新辅助治疗的争论中表明立场。（见下方幻灯片）
她指出 intismerna 缺乏 OS 获益，但对新辅助治疗也表示了同样的看法。她还指出，与新辅助治疗相关的毒性更大。
对于 intismeran，Svane 还提出了一个问题：究竟是什么带来了这款疫苗的获益——是对新抗原的特异性靶向，还是研究所提示的、mRNA 疫苗通常能提供的普遍性免疫增强？
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INTerpath-001: Phase 3 study of the mRNA-based individualized neoantigen therapy (INT) intismeran autogene (intismeran) plus pembrolizumab (pembro) vs pembro alone for adjuvant treatment of resected stage IIB-IV melanoma (MEL)
https://esmocongress.esmo.orgINTerpath-001
https://esmocongress.esmo.org- Robert Kemp@RSKemp01
@buildhealthspan @adamfeuerstein My point wasn’t about those. It was that if we can’t (yet) see an OS signal of pembro vs placebo. The probability of seeing one when event rate is lower because all got pembro in this study is very very small.
- Healthspan Builder@buildhealthspan
@RSKemp01 @adamfeuerstein None of those trials have shown an improvement vs pembro.
- Adam May@A_May_MD
@buildhealthspan @adamfeuerstein Wow great insight Machiavelli
- Robert Kemp@RSKemp01
@buildhealthspan @adamfeuerstein Pembro absolutely showed an RFS benefit.
- Healthspan Builder@buildhealthspan
@RSKemp01 @adamfeuerstein None of those studies showed improvement in RFS, $mrna vaccine has.
- Healthspan Builder@buildhealthspan
@A_May_MD @adamfeuerstein That is how the world works.
- Robert Kemp@RSKemp01
@adamfeuerstein Would have loved to see the antigen breakdown. How much overlap? Any differences in number of antigens in the vaccine?
- TOO SIMPLE, SOMETIMES NAIVE. 懂了没啊？@2_Simple_Naive
@adamfeuerstein Nothing worse than investor trying to save their own bags… discussant was clearly very fair on both ends lol
- Adam May@A_May_MD
@buildhealthspan @adamfeuerstein And that is highly objectionable behavior.
- Robert Kemp@RSKemp01
@buildhealthspan @adamfeuerstein I think possibly the most important was the discussant showing we haven’t been able to move OS with pembro (yet). I dont think we’ll get that with this. That doesn’t take away that completing it was impressive
- Mike Plage@MikePlage67021
@adamfeuerstein @JacobPlieth @A_May_MD IF the construct is doing the job, then - does mRNA vaccine ever work?
- Healthspan Builder@buildhealthspan
@A_May_MD @adamfeuerstein Cool. Should be is not the same that would be. Merck will not run that clinical trial….
- Bio-brain_2035@2035Bio
@adamfeuerstein The placebo of that trial is beyond comprehension
- Adam May@A_May_MD
@buildhealthspan @adamfeuerstein Correct. And there should be.
- Adam Feuerstein ✡️@adamfeuerstein
@JacobPlieth Indeed!
- Healthspan Builder@buildhealthspan
@A_May_MD @adamfeuerstein There is no phase 3 of pembro monotherapy in neoadjuvant setting.
- Jacob Plieth@JacobPlieth
@adamfeuerstein You could say, she didn't go "the whole Brahmer".
- Healthspan Builder@buildhealthspan
@adamfeuerstein This is the most important slide. Is the first trial ever that has shown to improve the efficacy of PD-1 in adjuvant setting.
- Adam May@A_May_MD
@adamfeuerstein “Greater tox” is because she was comparing it with the a PD1 *plus* CTLA4 regimen from NADINA, not a pembro monotherapy study like interpath and SWOG1801 both were.
- Billion Beers@billionbeers
@adamfeuerstein So basically a big nothing burger from $mrna
来源：Adam Feuerstein ✡️ · x.com