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SRX - Sirtex Medical

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Hi Galumay

I agree with what you are saying.

I was just surprised at the level of my emotional reaction to something that was not unexpected and I had had plenty of time to think through prior. Normally under such circumstances my prior reasoning would have moderated the natural response to a degree. The size of the emotional reaction has me questioning if my subconscious thinks my conscious reasoning needs some scrutiny or do I just have to drag my sub-conscious into another level of comfort zone. Nice to have the trading halt whilst pondering that question.
 
So far this company is a massive error of commission for me. I think it was under $5 when it was first mentioned to me.

Mistakes sometimes double as education benefits - but only if they improve or redefine your thinking in some way.

It does raise a few themes / biases for me and certainly not limited to SRX:

Circle of competence vs an excuse / laziness / fear / underestimating own ability of looking at some complex

Yes circle of competence can be expanded, and indeed, companies that have niche understanding, or are completely & widely misunderstood can be very fruitful investments.

Future cash flow growth (uncertainty) vs existing profitable cashflow but lower growth opportunities (alternatively seen as low yield vs higher yield) - it is easy to have a bias towards something that already exists, but it's potentially less profitable as an investment unless there is widespread uncertainty of its continued existence. For me it is kind of an issue of sooner vs later.

In a sense, when it comes to business analysis, it doesn't matter, because all businesses need to be evaluated on their future cash flow not their current or past cash flow (although these can be certainly used to inform forecasts. Effectively though, it is a false dichotomy that I am myself guilty of creating, and often.
 
Ves said:
So far this company is a massive error of commission for me. I think it was under $5 when it was first mentioned to me.
Click to expand...

Error of ommission.


May be it's because the news is coming a bit earlier than the "late March" flagged by most? This information alone, however, shouldn't be an indication of one way or another. And in your mental "preparation", were you expecting a trading halt? May be that element was unexpected?

Anyhow, no amount of quality analysis and decision making can influence the actual outcome. So an adrenalin rush from facing the unknown seems perfectly normal.

P.S. Brushing up on the stock now... my guess is the open price will be a massive over or under-reaction!
 
So it failed on primary endpoint (colectoral) but achieved the secondary endpoint (liver).

I don't know the company and its operations well enough to add my thoughts, but it would appear that this "failure" isn't as bad as it might first seem due to SirSpheres being designed for use on the liver?
 

That's a mixed result at best and as the primary endpoint was not achieved its not a pretty headline. I suspect the uncertainty until the data is presented is going to cause a fair bit of volatility in finding a new lower price level.

Fun and Games in the market today.
 

I don't know my medical stuff any better than you, but here's my interpretation.

- A study doesn't just choose primary end point randomly. It choice one for a specific reason so a fail is a fail.

- This update will highlight further risks in the failure in the June result (the chance of the failure perhaps hasn't change, but it will be brought top of mind).

- SRX ran really hard into the result... it's set up for a large fall even just for the froth to come out.

Definitely the stock to watch today.

P.S. It's a shame that the test wasn't a booming success. It would have been very good for the cancer sufferers.
 

Free money!
 
So 90% of patients with mCRC die from liver failure. The Sirspheres have been shown to improve the chances of progression free survival in the liver. How does that not improve overall progression free survival?
 
McLovin said:
So 90% of patients with mCRC die from liver failure. The Sirspheres have been shown to improve the chances of progression free survival in the liver. How does that not improve overall progression free survival?
Click to expand...

I dont know, but Mr Market doesnt like it!!
 
The SRX preso on 12 December 2014, from about page 41, explains the "What does it all mean" questions in layman's terms, and even defines the language used "progression free survival", "primary end point" etc.

Might be worth a read if you're stuck.

Edit: the October 2014 "Clinical Studies Update" is also pretty handy.
 
McLovin said:
So 90% of patients with mCRC die from liver failure. The Sirspheres have been shown to improve the chances of progression free survival in the liver. How does that not improve overall progression free survival?
Click to expand...

I am sure it does but it's about the p-value. They didn't actually announce the p-value so u don't know whether it's a big miss or small miss.

Anyway... had a plan to buy <$15 so loaded quite a few on open. Feels good that the plan worked. Out of most of them now and will hold a small lish position for the next few days.
 
McLovin said:
So 90% of patients with mCRC die from liver failure. The Sirspheres have been shown to improve the chances of progression free survival in the liver. How does that not improve overall progression free survival?
Click to expand...

Im not up on medical studies, but is it possible that it improves the PFS in the liver, but the tumours elsewhere progress (eg colon for mCRC) and a patient dies not of liver failure but of other organ failure?

I've interpreted the definition of PFS in liver not as patient survival but a measure of tumour progression in the specific organ (guess you could also have a PFS of kidney, lung, etc), eg PFS = the amount of time from treatment until tumour progresses. I interpret overall survival as patient survival.
 
McLovin said:
So 90% of patients with mCRC die from liver failure. The Sirspheres have been shown to improve the chances of progression free survival in the liver. How does that not improve overall progression free survival?
Click to expand...


We do not know from the announcement whether the primary end point failed because there was no clinical improvement in OPFS or if the trial failed to achieve statistical probability that any OPFS change was due to the treatment arm.

We will have to wait for the trial data to clarify but it is possible that there is clinical improvement in Overall Progression Free Survival but the trial failed to establish beyond 95% probability that it was due to the treatment arm.

We know from the announcement that secondary endpoint of progression free survival in the liver is both statistically significant and clinically significant – we don’t know how significant until the data. (At the minimum this is positive for the Sarah trial, which is looking at HCC, primary liver cancer)

Perhaps the reconciliation of the two outcomes is that the primary endpoint of OPFS only failed statistically. In which case that failure is not going to temper too much how the secondary end point results are viewed when full data is released.

The study data is still going to be presented – this would only happen if they have data they want to shout out to the oncology world – you sweep the bad trials under the carpet not present them.

If it’s a statistical failure with a positive clinical outcome – then we only need to look towards the next trials (or a new bigger trial) for the statistical proof. In the mean time oncologists aren’t going to totally ignore the clinical results, just as they haven’t to date which is why there has been 40 consecutive qtrs of dose sales growth.

We really know little from the Announcement – The market unsurprisingly didn’t like it, but then how smart is the market?

Gotta love the market - goes from pricing in near nose bleed probability of successful result to well below my total trial failure price on mixed and largely uninformative information.

Bring on the data.
 
Hi Guys,

I am not an investor in SRX. If someone has a link to the specific study, I can read it and perhaps interpret why the market has reacted poorly to it.
 
McLovin said:
So 90% of patients with mCRC die from liver failure. The Sirspheres have been shown to improve the chances of progression free survival in the liver. How does that not improve overall progression free survival?
Click to expand...

The devil will be in the detail. Oncologists won't be using such drugs based on statistical trends, there must be a very clear statistically significant benefit for the use of a particular drug, they are very particular about this sort of thing. It's not easy to get medicos to change their practice or to suggest new drugs to patients unless there is evidence that shows that it works. The cost of such treatments also comes into play. If the data only shows a trend (not statistically significant), you can pretty much ignore the results until a new trial comes out that has a large enough sample size to show a statistically significant result, obviously if the treatment has strong evidence behind it then the cost doesn't particularly matter, but if the result clearly isn't in its favour then the cost comes into play, particularly in the public system.

In terms of primary endpoint and secondary endpoints. It's important to understand the differences between these two. A study is usually designed to study a primary endpoint. The whole trial is designed around this possible finding. The secondary endpoints are aspects of data that are studied along the way but aren't necessarily designed for if that makes sense. As such, the secondary endpoints often (not always) aren't definitive enough to go by from a clinical point of view as their results can often be skewed by various confounders.

Hope that makes sense. Its hard to comment on the SRX results without reading the paper.
 
A good reason for not putting more than 20% of total equity into any one stock.
 
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