Nice comments, tuck.
I really never got into it here, but I will comment briefly on my thoughts and fav programs at JUNO.
First off, though, I need to give my overall rationale for my current enthusiasm in this autologous cell therapy approach using transgenes. The recent JUNO purchases of mine represent a significant initial investment in the this potentially transformative series of hematological and possibly solid tumor approaches as curative medical triumphs. I have watched KITE and JUNO since each went public less than three years ago. I just thought that the time was not quite right for me as an investor as several tough issues needed to be worked out; I wanted to wait for the euphoria of "transformative medicine" to wane. Things like the proper constructs and genomic insertion strategies, scale up of the cellular product and GMP production scale, how to deal with patient crises and deaths in these fragile patient populations, and closer to approvability, cost and the payor issue.
I like both KITE and JUNO at this point, as I think some of my worries have subsided. KITE's progress in their pivotal trial with the KITE C19 "drug" for the treatment of refractory/aggressive NHL is important for my investment thesis, but the response rate is truly not curative for all treated patients (ie, ave overall patient response rate of 54%). Meaning to me that a new product candidate for JUNO is not all that far behind KITE, or may be even ahead, in this C19 strategy, in terms of best in class. (I may like KITE even more after their follow-on offering clears, but have never held KITE shares.)
<You haven't talked much about which programs you think have the best chances, but I'm sure you have an opinion.>
The programs I currently like most (ie, have the best chances) are several, including those in any aggressive hematologic indication, specifically any aggressive.resistant form of NHL or CLL, and of course in ALL.
Obviously the solid tumor programs are in the first inning, so this is what an oncologist would call "watchful waiting".
<Currently, 017 seems to be addressing a smaller market; I don't now now what populations they're enrolling in the pediatric trial. Do you have a favorite in the remaining two CD19 programs?>
Not particularly. But I do look forward to their new agent to be explored in ALL. I copied the following from the JUNO recent PR:
"We intend to begin a trial with a defined cell product candidate in adult ALL next year."
I also note that RBC thinks the JUNO pre-conditioning regimen with fludarabine higher dose than KITE may be in part the ultimate culprit in the cerebral edema/neurotox/patient death issues, and I think this is similar to the JUNO thinking, but they cite other issues as well. Note also KITE had patient deaths likely attributed to drug, but not as penetrant (KITE had a fatal MI in at least 1 patient in the face of the CRS). |
