Measure 12 Times and Cut Once

Feb 16, 2024

The expression, measure twice, cut once (or, more humorously, measure once, cuss twice), means that care taken in advance will prevent the commission of later errors. A related Russian proverb is “measure seven times cut once,” which counsels even more careful preparation prior to action.

At EpicentRx, our interpretation of these expressions vis-à-vis RRx-001 (nibrozetone) was to measure twelve times, cut once.

RRx-001 (nibrozetone) is not your typical, run-of-the-mill small molecule that follows a well-established blueprint already laid out for it by similar-looking and acting predecessors. Heck no, definitely not. RRx-001 (nibrozetone) comes from the aerospace and defense industry, having been modified from trinitroazetidine or TNAZ, a component of rocket fuel. Nothing remotely like RRx-001 (nibrozetone) had or has ever been seen before in the pharmaceutical industry. Its biology and mechanisms of action were ‘known unknowns’ at the start of development. So, being truly one-of-a-kind and first-in-class, no blueprint for it exists.

This was the reason to proceed slowly and to put RRx-001 (nibrozetone) through its paces in 12 clinical trials i.e., we measured 12 times to find out in what indications it worked best. These indications are SCLC where currently RRx-001 (nibrozetone) is in a randomized Phase 3 clinical trial called REPLATINUM and severe oral mucositis (SOM) where RRx-001 (nibrozetone) will soon start a randomized Phase 2b clinical trial called KEVLARx.

This gives us a Plan A (SCLC) and a Plan B (SOM).

Which means that over the next year, having narrowed down the indications to two, we will have measured twice and cut once, hopefully for final FDA approval.