In ovarian cancer, we have kind of a spectrum of patients. Uh, almost all patients in the front line are treated with, uh, cytotoxic chemotherapy, generally a platinum containing chemotherapy with Taxol, uh, and, if possible, cytoreductive surgery. Um, the key being that the majority of patients, unfortunately with ovarian cancer will recur. And although we've come a long ways in recent history with maintenance therapies, uh, after frontline chemotherapies that have helped a number of patients, we still see the majority of patients. Uh, that are diagnosed with platinum with ovarian cancer, at some point developing platinum resistant ovarian cancer. Um, and platinum platinum resistant ovarian cancer is an incredibly difficult disease to treat. Uh, we've been trying for many years to develop new agents and new drugs, uh, to try to help our patients in this space, and we still use a phase 3 trial published almost 12 years ago, uh, which is our baseline reference for chemotherapy in the platinum resistant setting. Uh, that trial was called Aurelia, and, and in that setting, chemotherapy plus a vastad had a medium progression free survival of about 6 months, where chemotherapy by itself was about 3 months, and there was a small but not clinically significant benefit in overall survival for adding avacid to chemotherapy, but it goes to show that that is still the control arm for many of our our clinical trials in the platinum resistant space. Uh, more recently, the approval of Ela here, which is an antibody drug conjugate to the Foley receptor, uh, as well as the generalized approval for HER2 antibody drug conjugates, uh, across multiple diseases have both helped subset the population and plat platinum resistant ovarian cancer. Uh, but overall, we still are stuck with chemotherapies that don't work near as well as we would like them to. We have tried immunotherapy in a number of different settings with ovarian cancer. We've tried immune checkpoint inhibitors in the frontline setting, and the maintenance setting, as well as in the platinum resistant setting. And historically, the response rates to checkpoint inhibitors, especially with platinum resistant ovarian cancer, have been in the 10% range with a, with not a significantly meaningful improvement in progression for your overall survival. And, and so at the current time, there are no approved immune therapies in platinum resistant or even in platinum sensitive ovarian cancer. Um, although we've investigated them in a number of different settings. Uh, currently under clinical development are a number of different types of immune therapies including checkpoint inhibitors and by specific T cell engagers, uh, as well as cellular therapies, which may hold some promise, but they're still a ways away from reaching uh clinical fruition.
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