NorthWest Biotherapeutics Inc (NWBO)

[Pyrrhonian]

DCVax-Direct? Or BCG and interferon? Or both?

http://sttp.healthsciences.ucla.edu/abstract/sttp-abstract-current?abstract_id=2455

states the substance injected into the tumor microenvironment as "bacillus Calmette Guerin (BCG) and interferon (IFN)-gamma" mixed with DCs.

BCG has been used to treat cancer for some time now. Studies have shown its effectiveness is enhanced by interferon gamma:

http://www.hindawi.com/journals/au/2012/181987/

Studies have also shown that these can cause ideal maturation of DCs such that they can stimulate higher proportions of specific T cells as well as IFN-y secretion by these T cells:

http://www.translational-medicine.com/content/1/1/7

The question left to answer is, will BCG and IFN-y mixed with DCs produce a stronger effect than BCG + IFN-y alone? Or BCG + IFN-y + IL-2 (or IL-10, or 12)? The answer will take time. BCG + IFN-y alone has produced strong anti-tumor effects (as noted above), and especially when combined with IL. Time and additional studies will answer questions. All the better if through the Adaptive Licensing pathway.

The conclusion is especially appropriate:

Bladder cancer is a disease that places significant social and financial burdens both on the patient and on society, costing nearly $4 billion annually in the U.S. BCG, which stimulates a robust immune response in most patients and has become the standard of care after surgical resection of nonmuscle invasive disease. However, despite treatment, a significant portion of patients still recur or are intolerant of BCG side effects.

Multiple immunotherapies including IFN-a, IL-2, IL-12, and IL-10 have been investigated, either as adjuncts with BCG or as a solo replacement therapy. To date, there are a multitude of encouraging in vitro and murine studies; however, no clinical data has yet been reported which is compelling enough to change the standard of care, yet many practitioners continue to use adjunctive immunotherapy based on basic science data and theoretical benefit. At our institution, for instance, BCG or BCG/IFN- refractory disease is often treated with “quadruple therapy”—a combination of BCG, IFN- , IL-2, and GM-CSF.

The widespread use of immunotherapy for bladder cancer highlights the need for additional basic science and clinical research to further our understanding of tumor biology, human immunology, and the treatment of urothelial carcinoma.

Time will tell.