About the intismeran presentation at #ESMO26 $MRNA $MRK
My impression of discussant talk given by Inge Marie Svane of the University of Copenhagen was that she was positive if not overly enthusiastic about INTerpath-001.
"Measured" might be the best, single adjective.
"Brutal" is how an investor in the audience described the tone of her talk to me. (He was short Moderna, so there's that.) I disagree. Brutal is too harsh. If people were expecting Svane to jump for joy, then yes, she did not meet that expectation. To me, she played it mostly straight down the middle.
She took no position on the mRNA vaccine vs neoadjuvant debate. (Slide below)
She noted the lack of intismerna OS benefit, but said the same about neoadjuvant therapy. She also noted greater toxicity associated with neoadjuvant.
For intismeran, Svane also raised the question about what exactly was driving the vaccine’s benefit — was it the specific targeting of the neoantigens, or was it the general immune boost that studies have suggested mRNA vaccines generally provide?
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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