Dr. Brad McGregor

I think to your point, Alan, can we use CTNA to maybe de-escalate?

Can it be an adjunct to scans?

I think it's certainly very appealing.

And it does make patients feel better when they're still adamant on the scan.

But I'd say we have to stop it for neuropathy because you've had like

eight months and expect real instructions, but your CTA is negative.

And what does Dupembro?

And it does give that level of reassurance.

So I do think as we look to the future, CTA clearance is probably going to be, I mean, we've seen that in the perioperative setting, the patients with clear CTA do better.

It's probably going to be the same in the metastatic setting, right?

I mean, there's data out there.

And so can we start thinking about CTA clearance as a novel biomarker, a novel like endpoint and thing to look at in some of these metastatic settings to help us deescalate

Right.

Yeah, I mean, so when we did the DAD trials, that's double-amplified drug quantity, EV, SG, post-platinum, post-IO, 22 patients, we actually showed that you can combine them at full dose together.

And although toxicity is at full dose, the best sort of bang for your buck is probably full-dose EV with dose reduction and SG.

eight minutes per K in the trial that we did.

But we saw a 70% objective response rate post-platinum and post-IO, and five of the 23 patients have durable CRs over two years now without disease.

So pretty exciting.

I mean, small numbers, but that's the foundation for the DAD-IO, so DAD-IO, EVSG plus PEMBRO.

So this trial is open to Dana-Farber.