[Ed. Note: Dr. KSS writes about medicine and biotech stocks for the Irregulars. He’s agreed to our trading restrictions, chooses his own topics, and his words and opinions are his own. You can see his past articles and most recent comments here.]
The death of Mr. Chiang, who was always kind, has never set well with me.
Three years ago, Mr. Chiang, the father of a close friend in Taiwan, died of lymphoma. The family were exceptionally devastated: his illness had dragged on for 15 years, and they could be forgiven for a casual misperception that doctors would just keep treating it forever, just keep melting it away with another round of rituximab and CHOP chemotherapy. This was an elite family by Taipei standards, and perhaps somehow they thought ordinary rules of mortality did not apply to them. They were well-to-do, owned an apartment in a fine part of town that smacked of comfort and culture. Father and mother were both graduates of tony National Taiwan University, and so were all three of their children. The oldest was a physician who’d also graduated from medical school at NTU. The second child, a daughter, had earned a PhD in pharmacology at NTU, and during those years I had mentored her because I’d done postdoctoral work in the same laboratory. She was now president of a formidable contract research organization in Taiwan and ran clinical trials for pharma majors all over the island. At home, among each other, they spoke Mandarin Chinese, not Taiwanese. None of them felt they were any good at the more difficult nine-toned Taiwanese, the language of the people, and so chose to communicate more formally.
Insiders in the clinical trial industry often joke about lymphoma trials, and along these lines. Show us something, anything, that REALLY works in phase 3 for lymphoma, and not just in surrogate endpoints (endpoints other than overall survival, OS, which is all that is truly meaningful in an oncology efficacy trial). No, to heck with those “pilot studies” that get published and those rosy phase 2 trials with their cherry-picked super-ideal patients than never translate into phase 3 success. And spare us all these new ideas from start-up companies that you’re so cocksure are going to mop up the lymphoma landscape. Please. Indeed, for people who are part of the medical profession, and with that I include doctors and nurses and the ...