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Re: AVII77 post# 139187

Tuesday, 10/17/2017 1:59:31 PM

Tuesday, October 17, 2017 1:59:31 PM

Post# of 687017
Hi Avii… your post to me didn’t show because your first line was comprised by code “

” and hence doesn't show up. So it could only be accessed on the moderator board. You probably hit the return button after that.



Regarding a supposed interim analysis to have been done in the Summer of 2015.

Two things.

One:
It's reputed that Les has denied this claim to several investors.



Senti, is he purported to have:
1. Denied an IA was performed in summer 2015? Or
2. Denied the trial failed in the summer of 2015? Or
3. Denied a futility rec in the summer of 2015?

I don't believe he is purported to have denied 1 or 3 above. I believe some have interpreted a denial of 2 above to mean a denial of 3. They are not the same thing.

Regarding your AA scenario : have you read the recently published Rindo paper in Lancet? Did you see what they said about historical controls? It was presented as an old lesson relearned.
"Even carefully assembled historical controls can be misleading and an unsuitable basis for clinical trial designs"



Regarding Les’ statement to a shareholder about whether a first interim analysis was done or if the trial failed in the summer of 2015… my recollection was solidly that it was in regards to whether an IA was done. Remember FKO/Koman was strongly suggesting that it had been done. And I believe it was Chris who then said it had not been done. I don’t recall it ever being a topic as to whether the trial had actually failed then. However, if it was, I’m sure you’ll find it, lol.

As for the historical controls statement you quoted above in the Lancet journal article on the Rindo trial.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30517-X/fulltext

First, I believe they are referencing using their own historical data - specifically the ACT III as a basis for the design of their P3 study. I think that because they reference this because the article states the following a bit earlier in the piece.

The results of ACT IV also question the predictive value of both historical control datasets (matched patients from non-study databases) and small randomised phase 2 trial datasets (such as ACT III) as a basis for the design of phase 3 studies.

I’d also like to suggest that any comparison to the Rindo trial would likely be considered “concurrent” and not “historical” as this trial was, for the most part, enrolled at the same time as the DCVax-L trial was. It enrolled from the same source population, however it did enroll a GBM subtype - EGFRviii. However, this expression is found typically in the classical subtype, although it is also found on the neural and pro neural subtype.

Specifically, the EGFR family of antigens including EGFR and ERBB2 were frequently found to be overexpressed at 80% and 24%, respectively, within the classical subtype, consistent with previous reports. Within the neural subtype, EGFR (54%) was frequently expressed; whereas within the proneural subtype survivin (32%) and Sart-1 (25%) were more commonly expressed.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881271/

So will this Rindo group fully represent the DCVax-L cross over arm group? Perhaps not, but I'd suggest that they represented the group who typically has a longer prognosis than those in the DCVax-L trial. As I understand it, they had fully resected surgeries, the classical subtype typically performs better with SOC, and it would seem they removed the rapid progressors from their trial and left the psPD patients in. In other words, acting as a concurrent control would mean they represent possibly the best performing GBM patients on SOC. But… regrettably, I’m sure you’ll find a way to argue that’s not the case. In the meantime, perhaps we can all look for the missing protocol for that Rindo trial.
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