The NAPOLI 3 trial, which was already published, that was a large randomised phase III clinical trial. There were 770 patients accrued over 18 countries and that showed that NALIRIFOX was actually better than gemcitabine and nab-paclitaxel. It improved overall survival.

This was the post-hoc analysis where we looked at the 120 North American patients that were treated with NALIRIFOX and we wanted to look at the patients that were long-term survivors, so they were actually surviving greater than 18 months. Out of that 120 patients, 15 of them were actually long-term survivors and we wanted to present the baseline characteristics for these patients.

What did you find?

Interestingly, in terms of the patients that were the long-term survivors, there were some of the similar characteristics we expect with long-term survivors: ECOG performance status of zero, having a low CA 19-9 – it was about an average of 166 for the long-term survivors compared to over 2,000 with the other group. But also some of the interesting things we observed was that these patients also had greater than three metastases, so there were actually liver metastases which is a negative prognostic indicator. But what we did see was that in terms of the patients that actually were long-term survivors, there was actually about two-thirds of the patients had dose reductions and about 85% or so actually had dose delays which indicated that in terms of managing the toxicities for these patients it was really, really important to actually get them to be able to stay on therapy for a longer period of time and actually have an improvement in overall survival.

What are the clinical implications of these findings?

So I think the impact is really in terms of really selecting our patients and being able to manage their toxicities really well and being able to keep them on treatment for a longer period of time is going to actually have an impact. The median overall survival for that group of long-term survivors was about 19.5 months which is significantly better than what we’d normally expect with standard of care chemotherapy where typically survivals are usually 8-11 or so months. So having this subpopulation of patients that are long-term survivors if we’re able to actually manage their side effect profile better and keep them on treatment longer we can have a significant impact in terms of improving survival.