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No problem senti. I also use transcription software assisted by AI, which puts in punctuation, and paragraph breaks, but yes, it still requires considerable corrections, or “scrubbing.” One really nice thing, is that it removes all the “uh’s.” If you’ve ever transcribed one of Linda Liau’s presentations, (which I’m pretty sure you have) you know what a time saver that is!
Transcript of 2023 ASM held June 29, 2024
The transcript begins at the conclusion of the formal business, at approximately minute 19:
AUDIO REPLAY: 2023 Shareholder Meeting (through Jul 7, 2024)
https://nwbio.com/audio-of-nwbio-2023-annual-shareholders-meeting/
Having concluded the formal business, we have no other business that was properly brought before the annual meeting of stockholders. Within 4 business days, we will provide the final voting results in a form 8k filed with the SEC, Securities and Exchange Commission. I would now like to take this opportunity for an information discussion, informal information discussion, in regard to questions submitted by stockholders in advance of the meeting. We may have to make this point. We may make forward looking statements during this discussion, and our actual results may differ materially from those forward looking statements.
You should not rely upon forward looking statements, and you should read Northwest Biotherapeutics Inc. periodic filing with the US Securities and Exchange Commission for a nonexclusive list of risk factors related to our business and operations that could cause actual results to differ materially from any forward looking statements provided during this meeting, and discussion. And now without further ado, we'll transition into that discussion. So now it can be a little more informal. Right?
This is meant to be a discussion of questions, that we're aware of, that shareholders have submitted or shareholders have raised with us. First thing that, what? Before I dive into the discussion, I think all of us at Northwest, I speak for all of us, wanna really thank all the stockholders for the tremendous voter turnout, and the tremendous, number of shares voted for this annual meeting. We really appreciate it, and we really appreciate the positive votes.
And we, we're just tremendously thankful and appreciative for that. We got a lot to discuss today, and we hope you're gonna find it exciting. And you're gonna leave the meeting feeling as excited as we do about the progress we've been making, and what our plans look like going forward. We plan to spend up to about an hour in this discussion, and we will, I will go through kind of a lot of information, that we've collected and that we think covers most of the questions, that we're aware of, that have come from shareholders. So I'm gonna start by, I'm gonna talk about the MAA, about developments at the Sawston facility, about progress with FlaskWorks. Also, gonna talk about some of the new exciting IP that we've acquired, and an update on our groundbreaking lawsuit against the folks that we believe have been manipulating our stock price.
So that'll be a kind of recap of where have we come in the last 18 months since the last annual meeting of shareholders. It's been a a busy period. After reviewing, the recapping the past 18 months, we're gonna look forward. And I'll describe our planning and our priorities for the next approximately 18 months.
And we think we hope that you'll find that exciting at with, a lot of anticipated, growth areas and potential progress. So, I wanna just go through some of these particular subject areas, for the last 18 months. So recapping where we've come to, over the last 18 months. First of all, near and dear to all of our hearts, is the MAA, for the commercial approval, application for the commercial approval of our DCVax-L product for glioblastoma brain cancer in the UK. And during this past period, key things that have been accomplished relating to this.
First of all, as you may recall, there were quite a few very significant prerequisites, that we had to complete before we were even eligible to apply. And that was in addition to the clinical trial results from our phase 3 trial. So we had to get 3 licenses for the Sawston facility. We had to get the initial license. We had to get a human tissue authority license. And then, most importantly, we had to get the MIA commercial license.
And that license, which was obtained in March of last year, was one of the first that's been granted for cell therapies in the UK. All of those licenses, the work was done, and the license was obtained, by Advent Bioservices, that worked with us. Another key, prerequisite that we had to do before being eligible to apply with the MAA, related to pediatric, treatments. We had to have a pediatric investigation plan, a PIP, which seems like a very English term.
And, the PIP had to be submitted to the regulator, and approved by the regulator, MHRA. And, so that was accomplished, and in fact, was accomplished in, what we understand to be, approximately half the usual amount of time. MHRA has been wonderful. They have given us rapid turnarounds, more than we could have expected or hoped for, in the steps that we've had with them so far. That doesn't necessarily predict anything, but it's been it's been a really great experience so far.
So completing all of those prerequisites, there were a lot of preparations as well, that kind of our surrounding context of the application itself. Pulling together the enormous, I mean it’s, it's just an enormous paper exercise, the trial master file. I don't even, I mean, I'm told it's a couple hundred linear feet of paper. I've seen it. I haven't measured it.
It's ginormous, and you cannot have any gaps. And when the inspectors come and they say, I wanna see the lab tests for patient X at clinical trial site Y, you have to be on top of that, and go right to it, and pull that page right out, and be ready for them. And we're talking an enormous trial master file. This phase 3 trial was one of the largest clinical trials of any, of a cell therapy product, particularly a personalized cell therapy product, that anybody has conducted.
And the trial master file is correspondingly enormous. That's just an example to give you a flavor. There's just a such an enormous amount, particularly to prepare for inspections, and that's a common theme you're gonna hear. We have been working our tails off with teams of consultants, because everybody's going to be inspected. We, the sponsor, are gonna be inspected. The contract research organization, who conducted the trial, is gonna be inspected. The document, the trial master files, its own, its own inspection. The independent database company that held the database for the trial will be inspected, the hospital sites, selected ones that were trial sites, are gonna be inspected.
So what I just described as the glimpse, the example, of the trial master file, every one of these parties has to have everything shipshape. And when they come with inspectors, our understanding from our advisers, is they will send a team of inspectors. Two, three, four inspectors, and they'll stay for a week.
That is a big undertaking. So we've been spending enormous amounts of time with all our teams of consultants preparing for all of those things. And we have gone through, audits, mock inspections. We hire people who used to be inspectors for regulatory agents and are now consultants, and we've gone through mock inspections. And each cycle is several months, and we get a report and then fix those things.
And so, anyway, that gives you a bit of a flavor. The drafting of the MAA package itself was a year long process as everybody knows. It was our Christmas present last year (haha) to to ourselves and everybody. Got it submitted on December 20th this past year, and had been working with medical writers since the fall of the year before. It was a multi thousand page, submission.
And then in the period since the submission, of course, there's been post-filing support. One of the things we are trying to do, working with consultants, a little bit like the practice inspections. We're trying to guess. We're trying to predict, what kind of questions might MHRA ask us about the package we submitted? And what kind of supplementary information might they ask us for? So that, to the extent possible, to send, to whatever extent we've guessed right with the guidance from all our advisors, who are experts in this, that will enable us to do a faster turnaround time.
That's the whole idea. We wanna try to keep the momentum, and keep up with path, rapid turnaround time. So that's a big area. As I think you know, also during this past 18 months, we we conducted and carried out and then publicly presented, all the, the results of our mechanism of action studies. These were, studies about the underlying biology of how DCVax works.
And our our chief technical officer, doctor Bosch, presented all that information in a company presentation during ASCO last year, and it was tremendously important because it showed with the underlying biology that DCVAX is what we've always hypothesized, it is. That it gave support for the hypothesis that it's a broad spectrum treatment. We reported that, in the examples that were studied, in those mechanism of action studies, the dendritic cells were picking up, and from the tumors tissue sample, the lysate, and presenting to the T-cells over 600 different tumor targets. So when we say it's a broad spectrum treatment, you know, that gives you a flavor of it. And those mechanism of action studies were really important to add more scientific underpinning that supports the clinical trial results that we've seen in the patients, and help support our MAA.
And we, it was very important, you know, we use proteomics technologies that are relatively recently developed. You know, proteomics, the study of the proteins, active agents, are not as far along as genomic, tools. And so we were using quite recent technologies in doing these studies, and that was really important.
We . . . on another front, we do continue to follow our patients from the phase 3 trial. We do still have patients alive. I'll remind you that the last patient was enrolled in November of 2015.
We also have, continuing our ongoing compassionate use program, we have not had as much activity in that while we've been so occupied with the MAA. But that program continues to give us really valuable real-world experience. You know, in a clinical trial, you try to do everything as cookie cutter as possible, as homogeneous, the same as possible, but that's not the way the real world is. And so, the compassionate use program has been so valuable for us because we've gained a tremendous amount. And we still are gaining tremendous amount of real world experience, basically practicing for when we're able to be commercial.
So we have patients who their tumor tissue sample isn't in the condition that it's supposed to be, or it hasn't been frozen quite the right way, or it was frozen several years ago, or the patients are way outside the age range. We have patients in their eighties, and upper eighties. So lots of real-world circumstances that, that's really been valuable for us. And, I think it's been very valuable for the patients too, which is quite important, and we are learning lessons. We have some very nice long term survivors, 8, 9, 10 years. And, so we are learning lessons from the cases of long term survivors as well.
Okay, another huge area of activity over these past 18 months has been in the Sawston facility. The development of it, not just the licenses, which I've already touched on. But let me just let me just, for a moment of history here, remind everybody, the very first manufacture of a DCVax-L product for a patient in the Sawston facility, product number 1 ever, was manufactured in February of 2022.
Just two . . . and and there's a press release about it, you can find it on our on our website. . . just two and a half years later, look at where we are. We've completed the phase 1A build out, the phase 1B build out. We have worked with specialized architects and engineers to design the grade C labs, that I'll talk about in a minute, that will be, for the build out going forward. We've gotten, Advent has gotten, all 3 of those licenses, and we're working on commercial readiness, less than two and a half years from the first product ever made GMP in that facility. So that's been a huge area of work. We're very proud of that progress, and it's a, it's a valuable facility.
One of the things we've mentioned, that you may remember from our press release earlier this year, about the progress on the FlaskWorks system, which I'll come to in a second, is that the traditional, type of clean rooms in a GMP, (good manufacturing practice) clinical grade manufacturing facility, are what the Europeans call grade B labs, the letter B as in boy. We would call them class 10, 000 in the US. These are the high level sterility, an entire air change of the whole suite 60 times every hour, I.E. full air change every one minute. Technicians wearing spacesuits, special water, special environmental systems, no particulates, whatever, all of that. Those are the traditional ones. They're super expensive to build. They're super expensive to operate.
What we are transitioning to now, and we're able to do this because of the FlaskWorks system, is we're transitioning to grade C labs, which would roughly be more like class 100, 000 in the US. In other words, it's a lower level of rigor and sterility, and you can only do that when you have your whole manufacturing process is done in a closed way. The word closed is a magic word in the world of medical manufacturing. Right?
When your process is closed, that means it's all kept within a machine, or within a bag, or within a flask, or something that's not open to the air. Because once it's open to the air, it's no longer closed, and then the air has to be basically perfect. And that's very expensive. So the FlaskWorks system has enabled us to transition first to being a closed system for the manufacturing steps, and also to start the process of automation, which is a separate thing and an additional benefit. So we've ,we as we look towards the further development of the Sawston facility, we are, we're moving into to, all grade C labs from here on out.
And another huge difference, just to crystallize it for you . . . In this grade B labs, the more, the more rigorous sterile ones, you can only produce one patient's product at a time. You have to clean the whole suite in between each product. Imagine that. And that's on top of all the special air, and everything that I just said. Okay. And that's because, if you're doing a procedure in there that, at least partially, is open. That's why the word closed is such a magic word. So in the grade C lab, because everything is, magic word . . . closed, you can, the regulators allow you to manufacture product for multiple patients at the same time in the same suite. So you can begin to see the efficiencies. So important.
So that this whole area has been a big amount of focus for us, and work. There's a lot of aspects. It's not simple. Nothing is simple, but it's not simple to change your planning from grade B labs to grade C labs, because not only is the size and the configuration, and so forth, different, even the load on the building is different. And, oddly, some of the load is more problematic, more challenging structurally, for grade C labs, than for grade B labs, which I was surprised about. But, anyway, a lot of work, big area, tremendous progress over the last 18 months.
Just before we leave that subject, in terms of capacity, our current anticipation . . . and this is, you know, based on assessments, by the Advent folks, who are the experts, is that we anticipate that each of the grade C labs should be able to, with two shifts operating, produce about a 1, 000 or 1,100 patients products per year, per grade C lab. Okay? And we anticipate, you know, we're so fortunate this building, is very large, and it's about, close to 88, 000 square feet on 2 floors. We anticipate, ultimately, when the building is fully built out, if it's fully built out with C labs, with our current understanding, and if the engineers don't change things, we anticipate being able to manufacture up to, up to potentially 15,000 patients a year, with all grade C labs in the rest of the building.
So you can start to see, even if we get part of the way towards 15,000 a year, that is an enormous amount of patients, especially for personalized cell therapies. My understanding is, for example, big company, the big companies who bought the CAR T cell technologies, in their first years of commercial operations, made 50 patient products. Right? So, you know, having the eventual capacity to make up to 15,000 patients would be absolutely enormous.
We also have been doing a lot of preparations of the nuts and bolts of things that would be needed for commercial operations. I won't take time on that, but just to give you one glimpse of it, again, giving you flavor. We have established, and it’s existing today, we have controlled clinical grade cryo storage for 3 million vials of doses. So, 3 million is a pretty good amount to start with.
Part of all this is not just the physical aspects of building out the Sawston facility, but there's a step that have, that you have to go through for any medical product for a human patient. And that is, after you manufacture the product, it has to go through product release, and it it has to go through quality control tests, using quality control assays, or tests, or analyses, that have been approved by the regulator. You have to test the sterility, the purity, the potency, the composition, all of that, of your product. Okay?
But you also have to check that all during the manufacturing process, all of those regulatory requirements were met. So you have to check the readouts from the environmental monitoring system to make sure that the the number of particles in the air in the suite, during the entire 7-day process, stayed below the maximum allowed. I mean, it's enormous. And the manual way of doing product release, is for a certified person, they're called a QP, a qualified person, is to manually review all those records.
Well, that can take up to 30 person hours to do that, and that's one thing if a batch of product is like a million tablets. But a batch of product of a personalized therapy, is one patient. So that would have been a bottleneck if you manufacture the product and you can't release it to be used in a patient. So we started, close to 5 years ago now. Advent has worked with a company. They've developed a system, and the system, I won't bore you with the details. We'll have more to say about it, in the coming weeks, and months. But the system essentially automates the product release process, and removes that, as or hopefully, potentially, removes that as a bottleneck. Certainly, greatly improves over the manual process. So, again, huge area of work.
Yeah. I'm taking too much time, so I have to hurry up. Flaskworks . . . I'll just say, 18 months ago, we, they had only developed one approach for the system. It was a good approach. It was attractive. It's part of why we acquired them from Corning, but it wasn't necessarily, specifically as optimized as we would like it to be. So over these 18 months more, we developed two other fundamentally different approaches to the automation, the closing, magic word, and automation of the manufacturing.
Did extensive testing, comparatively evaluated: how did the cells do? Were the cells stressed with one approach or another? Was the yield better? All that kind of thing you would imagine. Selected the best approach, developed, optimized a non-GMP, non-cleanroom version of the machine, and then, went through and, just in this year to date, we've done the adaptation of that, to go into the clean room. Which you have to use different materials, and you have to use some different mechanics and so forth, that I won't go into. So that adaptation work for GMP was recently finished. There are a couple of improvements that we are doing to streamline, and then those units are about to be ordered shortly. So that's the that's the clinical grade machines.
Les is going to, I guess, make a couple comments about the, about the role. Most of this work that I've described has either been carried out, or driven by Advent. So we know that stockholders had some questions about Advent: How our arrangements with Advent are, how we pay them, what the structure is, and Les is gonna give you just a minute or two on that.
Thank you. Advent provides a range of contract services to Northwest that is very important and significant in terms of having people on the ground in the UK able to do things like: manage the complete development of the Sawston facility, prepare for, and draft all the sections of the MAA, from a from a scientific perspective, and the writing on-site, detailed science, oversee the functionality, and the actual work done on the compassionate treatment program, again, all under contract to Northwest. Substantial inputs, as Linda indicated, into development of the Flaskworks system. It involves a lot of collaboration, and a lot of testing and a lot of, it's been amazing how much work has been done, and how great the people there have done on that. And the way that Advent is finishing up ,even right now, things like the restart of DCVax-Direct, which will be coming up, and has done put a lot of work on that in the last 7, 8 months. And and let me take on, and and state how we compensate them under these contracts.
And that is, that the payment structure provides a pass through of all baseline costs, and, a fee, if you will, for the administration of it all, which is a 15% on top of that cost. But Advent doesn't really realize any gain on any of that until they meet the milestones, like getting the MAA in, or or getting the facility going for the next phase of the of the C, the C, services. And so, we find that that kind of an approach is very favorable to us, and to Advent because of the assemblage of all the capability, not only on manufacturing, but on the experimentation, and the work that has to be done on the science side. And so that kind of a compensation is something that allows us to get services that would be far less costly than if we had to go to a third party provider that we didn't have this close intimate relationship with. And and it makes a lot of sense, and it's been a great relationship.
And we monitor all of these inputs very carefully. And, I oversee that. And, we just wanna give you a flavor of how all that works. A large chunk of what we, pay to to Advent is just pass through costs of of the work that they're doing with their personnel and the various contractors that they bring in to do things like get the facility put together, or to do the C labs. Right. Thanks.
Thank you. So we have kind of two more large subjects, to finish up the recap of the last 18 months. Having gone over the MAA, and the facility, and the Flaskworks and all that, Now I like to turn to talking for a minute about intellectual property and collaboration. That's been a a significant area of activity for us.
We've reached completion on some things that we're quite excited about. So I'll talk for, just a minute, a couple minutes about that subject. And then I'll finish by talking briefly about our lawsuit, and the progress of our lawsuit against the parties who we believe are manipulating our stock, and we'd like that to stop. Yeah, so would you, right? Little understatement of the millennium. Right?
Okay. Intellectual property. Let me start with the big picture point. Our goal is to build a franchise in dendritic cell technologies. We want to build a leading, and preferably THE leading franchise in this area. The mainstream thundering herd hasn't yet fully recognized the special capabilities of dendritic cells, but it's starting to happen more and more. If you noticed, for example, when the the federal government created a new agency, modeled on DARPA, the Defense Advanced Research Projects Agency, which they call ARPA-H, for Health, Advanced Research Project.
The very first grant that this elite technologies of the future agency awarded, was a large $25 million grant for Dendritic Cells Technologies, in academic setting. And that's just one glimpse, but increasingly, people are beginning to recognize the special capabilities of dendritic cells. So we are working busily to build a dominant franchise in the meantime, before the thundering herd arrives, or while they're on their way. (haha) So we have quietly, and you may, or may not have noticed, but in our 10K and 10Q’s, we have been quietly reporting that we have been in-licensing technologies that we think will be valuable for the future in building this franchise.
Now just recently, we announced one that was particularly big. I mean, ginormous. And that's the arrangement, the in-licensing package that we did from Roswell Park. But if you noticed, even in that announcement, we explained that that package from Roswell covered 7 years of work by this leading research group on dendritic cell technologies. But we had also completed last year, an in-license of a package of the original older foundational work, that that group had spent 17 years developing, at another institution. And we have in-licensed both of those packages. And we purposely stayed in stealth mode while we put all the pieces together, because we believe, in our own analysis, that the whole, the sum is greater than the parts.
And those two packages together have some just wonderful things in them. They include enhanced versions of dendritic cells. They also include technologies that are complementary to, to use with dendritic cells. For example, a combination treatment regimen, in a trial, or agents to just be immune booster agents, that kind of thing. And if you think about it, interestingly, this collection of new tools or technologies, gives us a lot of growth opportunities, which we can use together with our existing DCVax platforms, which as you know, we have two versions of the platform, DCVax-L for operable tumors, DCVax-Direct that you haven't heard much about recently, but which will be coming up again, now I'm happy to say, for inoperable tumors. We can use these complementary technologies with our own DCVax platforms.
We can even use them with other kinds of agents. You can use a conditioning regimen, for example, that's meant to condition the patient to have more of a response to immune therapies, or is meant to, as people like to say, reprogram the tumor environment, the tumor microenvironment, to be more conducive to an immune response. You can use those with any type of agent. So we could, we could do partnering with other companies who have, biologics, or targeted therapies, or checkpoint inhibitors. That could either be with the dendritic cells included, or with just the other agents.
So we start to have a pipeline that has complementary things, but has many permutations and combinations that we can can do. And, obviously, one of the really nice things about the package, and I was, we were surprised because people, maybe it didn't quite register. But as we said in our announcement, there are two phase 2 trials currently underway with these technologies that we in licensed. Okay? And these two clinical trials are fully funded by grants, and they're being fully carried out by the investigators.
So we don't pay anything, and we don't do anything. But these are the results of technologies that we now have. So those will be going along in the background in parallel, while we're busily working on the MAA, and all of that. And if they produce positive encouraging results, we will then take them on into phase 3. And, we we think Roswell, which is an absolutely top tier. If you don't know, it's a very prestigious institution, very top tier cancer center. We think they've done a marvelous job of developing the technologies at the research stage ,and then the early clinical trial stage, and even now into the mid stage clinical trials.
And we're really gratified that they chose us to pass the baton to, to take it forward, for late stage clinical trial ,and hopefully, eventually, the commercialization. So, these are some of the, intellectual property, but we've been quietly in-licensing quite a number of different pieces of technology that we feel will be useful building blocks in building our, our franchise. And we've also, been putting some collaborations in place. So we haven't announced those yet, but, those will be, something that will be coming along. Okay.
The last section for the past . . . and we went way longer than we're supposed to here . . . is our lawsuit against the seven market makers. You know, all of us, I don't have, I mean I hardly have to say this, but all of us are unbelievably frustrated that the share price is not yet reflecting the value that we are working to build. And we believe that our stock has been manipulated, and we believe that was going on for many years, and we were very anxious to try to take some action to do something about it. But we had to bide our time, and meticulously collect evidence and so forth, because the bar is extremely high. You, the degree of detail that you have to put in a complaint, is, hard to even describe. It’s, I mean, in our, so we did bide our time until we had, what we believe, is a very strong case put together.
We filed that in December of 2022, so just before the last annual meeting, And it has gone through, a whole lot of back and forth skirmishes, all of them relating to the defendant's effort to have the case dismissed, and never go anywhere, by filing a motion to dismiss. And we are very gratified that the magistrate and the court have found that the pleadings in our complaint have been sufficient on all but one of the elements that we have to plead, and that's in process. I'll come back to that. So what they found already, is that our pleadings are sufficient, to pleading that the defendants engaged in manipulation of our stock, and that they did so with scienter, with the intent to damage Northwest. Now, again, we're at the pleading stage.
So the court has only said that we have adequately plead this, but that's a very, very big deal, because these cases that the companies who've been the victims or targets or, never have pretty much not been able to get anywhere trying to seek redress with this kind of case, because you have to be able to articulate all the minute details of the transactions that you allege involve the manipulation. And you have to do that first before you can get to the stage of discovery, but you can't get the information unless you get discovery. So it's kinda like when you get out of school and you can't get your first job until you have experience, but you can't get experience until you have your first job. And so, for years and years, decades, victim companies have have been, unable to get over that bar. And I encourage you guys to read the complaint.
I mean, read it when you wanna go to sleep, but,(haha) I mean, we did our complaint details thousands of transactions down to the millisecond. We're very proud of this, and it, a lot of work went into that. And so, and and we've been vigorously pursuing this case. The only element that the magistrate and the court said that we hadn't plead sufficiently, was one element, which is referred to as loss causation, saying, okay, well, if they did manipulate our stock, and they did have the intention to harm us, you know, what's the connection between their bad behavior, and what damage we say that we incurred.
You have to be able to connect the dots. And there's a time element to it. Like, was it the same day? Was it within 24 hours? Is there a lingering effect that lasts? You know, all of that complexity. So the court, and the magistrate specifically gave us permission to amend our complaint, to strengthen the pleading claims on that one element. We've done that. It's been submitted. The defendants made their objections. We did our reply. So now we're just waiting for the magistrate to evaluate all this, and give their report and recommendation, which then subsequently the court will act, unlike before.
So I know it feels like it's taking a long time, because, you know, it's been a year and a half since we filed a complaint. And we've been fighting, you know, we we try to press the schedule, as much as as we can. But, actually, this is a pretty good pace, from what we understand. It's in line with other cases of this type, and actually a little bit faster even, than some other cases of this type. It's just that the wheels of justice grind slowly, but we are pursuing this vigorously.
So you’ll see that, and there are no guarantees, but we are optimistic about what the ultimate decision will be, about the motion to dismiss. Namely, we are optimistic that it will be denied and the case will be allowed to go forward. We believe our case is meritorious and strong, and we believe that the case may be an opportunity to recoup damages, and to get, what we believe, is manipulation, to stop. So this is a big area of effort for us, and we just want you guys to know that, because we're as frustrated as you, are about the situation.
Okay. That was a really long recap of the last 18 months. The looking forward, I can buzz through faster. Well wanna do, like, a 7th inning, what is that? What inning is it? 7th inning stretch. Anybody wanna do a 7th inning stretch? Get a drink, or whatever, cookie? Just had to check which inning it was. 7th inning stretch. Okay. I know it's way too long . . . .
Was just only meant to be, like, a minute, but, okay. So now we're changing focus to forward looking. And let me remind you what I said at the end of the formal meeting, which is, these are forward looking statements. The actual results could vary materially for lots of different reasons. Please read the risk factors in our SEC filings, and please don't rely on forward looking statements.
So what I'd like to do, is just give you a sense of looking ahead now, for the going forward 18 months or so. What are our priorities that we're gonna be focusing on? And I'm grouping them into 3 groups; our top priorities, our second priorities, and then our, as we can, as feasible, priorities. So I'll give you the 3 groupings, and I'll just, describe. So, needless to say, our top priority, our laser focus, is to complete the process, and hopefully obtain our first commercial approval in the UK, hopefully, approval of the MAA.
We're well underway. We believe the MHRA is following the 150-day process that they have, but we don’t, we do not have confirmation of that. We don't have a way to be sure of that, to know it for sure, but we believe that. It, the “150 days,” quote, unquote, involves approximately 3 stages, and the time frame of each stage is approximate. So it's not, you know, on the button.
The first stage is approximately 80 days of initial review of the application. The second stage is approximately 60-day clock stop, when the agency is going to deliver a list of questions to us, as they do in all these processes. It's not just us. They'll deliver a list of questions. They'll ask for supplementary information, all of that. And, and we will try to respond as fast as we can, which is part of why we're trying to guess what they might might ask, and try to already kind of prepare.
The 3rd stage, which will come after the 60-day clock stop, or however long the clock stop turns out to be, to provide all the answers and info, additional information. The third stage is approximately 70 days of further review, and reaching a decision. Again, the the timelines are approximate. As as far as we've seen, there is not an equivalent thing in the UK that's similar to a PDUFA date in the US. You know, under the legislation in the US, you know, FDA can have a target date for giving you a decision.
We don't have a target date. It'll be what it'll be, okay? And those approximate time frames of those 3 stages that I described, of course, depend also on MHRA's workload, and what backlog they have, and so forth. So that's the approximate process, and the approximate timelines.
I mentioned, with a lot of emphasis, and a lot of discussion about the inspections, that they're gonna inspect everyone, and everything. Those are gonna be going on all during this MAA review process, and those will have to be completed before an MAA decision can be rendered. Right? So there's gonna be extensive inspections, and it's gonna be going on, during this period.
So we, the typical thing, we are gonna follow the typical practice of biotech and pharma companies, which is, we are not going to provide interim step blow by blow. They asked us this, we answered that. They asked us the next thing, we answer that. No, we’re not gonna do the interim steps. We're just going to tell the result when the process is finished. That's the typical approach, and that's the approach that we're gonna be taking. Okay. That's our big priority area, of course.
Another big priority, in this grouping of top priority, is preparations for commercial launch. There, we've been working on this for years, as I've described, but there's still a lot to do. We're very excited about working on this. First off is, we anticipate that we will be beginning commercialization using our existing grade B labs. So we're gonna be pursuing the build out process for the grade C labs as rapidly as we can, but we're not counting on that to get started with commercialization. We're able to get started with our existing B labs. We will, and likewise, we, a part of this preparation for commercialization, will be finishing the process that we described with the FlaskWorks machine.
So now that the adaptation for clinical grade GMP, that design work has been done. The remaining steps are; complete the the streamlining, or condensing some of the portions of it, get the units ordered, have the units delivered, and then Advent will need to conduct a large amount of, what are referred to as, engineering runs. They're practice runs. You have to run, do practice runs with the Flaskworks machine in the Sawston facility, collect all the data, compare the data with the data from the DCVax products produced by the existing manual process, because they have to show, they have to demonstrate to the regulator, not only that the Flaskworks machine operates properly, doesn't shed particles into the clean room air, things like that.
We have to show that it produces a product that's the same, or as close to the same, as a biologic product can be. So they'll be in addition, after they do all of these engineering runs, and they collect all the data, they'll do comparability studies, equivalency studies, and collect the data from that. And then all of that will be submitted to the regulator, and the regulator will give approval. And this will all be going on, these are all things, all going on in parallel. Right? So this will be going on over the coming months, at the same time that the MAA process is going on, and the same time that the inspections are going on, and so forth. So it's not stretching out, you know, to infinity. It's parallel. What else on this? I think that's enough.
We definitely, we need to do some mundane things like expand our operating arrangements. We need to expand our contractual arrangements for leukapheresis, blood draw slots. You have to contract for those, and you have to pay for those. So it's such a little bit of chicken and egg, or a calibration as, you know, you want to have enough slots, but you don't wanna get too far ahead of yourself, and have your burn rate get too high before you need it.
So, anyway, we'll be calibrating, making contract arrangements for more of those slots. We will certainly need to expand the staff who will handle logistics, you know, mundane things like that. There's just a lot of mundane things to do, but it’s, it needs to be done. Among other things is, as part of the preparation for commercialization, we will need to determine what our pricing model is gonna be. What's gonna be the pricing model for DCVAX? That's something on which we will work with expert advisors, and, but it will be important, obviously. And, again, all these tracks going in in parallel. Okay.
After the MAA, and the commercialization preparation, and those activities, we also need to go through the process of applying for approval for reimbursement. So in the UK, that's a process that is handled by NICE. And NICE has been absolutely wonderful to us. I cannot say enough things wonderful about NICE. They've been supportive. They've been flexible. They're standing by.
We talk to them. They reach out to us every couple of months to check on the status of things. I mean, I couldn't imagine a government agency, that's been so supportive as they've been. What we will need to do is, we'll need to engage specialized consultants to develop, what's referred to, as a health economics model. We have to make an economic model about the cost benefits of the DC vaccine treatment, and how it fits with their policies, and that sort of thing. So, that for sure will be, in our grouping of top priority activities, over the, as we look forward, over the coming 18 month period, 12 months, whatever.
Of course we are anxious to submit applications for approval in other countries. We're very happy to be going through our first process in the UK, because they have the fastest process of any that we know of. And it's been really great, but, of course, we want to get start, getting applications put together, and that'll be another thing that we'll be working on during this period, and getting those prepared and submitted. We have a partial head start on them because one big component of the application anywhere, is the clinical study report, which is a ginormous document that has the 20 years of efficacy and safety data from every program that's ever been done in DCVax, even programs other than brain cancer. So, we have a partial head start, but applications in other countries will be important.
And very dear to our hearts, we need to expand the management team. We need to expand the management team rather substantially. As you probably have guessed, and as we described in the proxy, each of the core members of the senior team has been wearing multiple hats, has been fulfilling multiple roles. And I mean, multiple roles that would each be normally a separate senior management person at other companies. And I'm really proud that we've been able to do that, but we need to we need to ramp up. We we've got tremendous opportunity, and we need to ramp up. So that is going to be a significant focus for us, as soon as we can achieve it. We wanna be highly selective, but we plan to substantially expand the management team.
Okay, the last item in our top grouping of top priority, is what I've already mentioned, which is continue to vigorously pursue the lawsuit in New York against the parties, that we believe have been, and are continuing, we believe, to manipulate our stock.
Okay, second grouping of priorities for this going forward period: we plan to initiate the pediatric glioma trial. Just so everybody understands, that conducting the trial itself, is not specifically a requirement connected to our obtaining approval for our adult medicine. What was a requirement, it was in fact a prerequisite, and it was a requirement in order to, for our application to be validated, which it has been as we publicly reported. We had to have an approved plan. We don't have to have completed the trial. So we're going to be pursuing that.
It's been a very long process in the UK. It's been a year and a half of discussions with pediatric neurosurgeons, or oncologists. We actually just recently, finally, after a year and a half of all this, reached conceptual agreement with them. We are gonna be proceeding with just one of the two pediatric trials first, and then the next one will be in sequentially, rather than simultaneous, which is actually a good thing. It'll kind of reduce the bandwidth, and resource requirement on us. So that'll be proceeding.
We, as you can imagine from what I've already discussed, we'll be pursuing build out and equipment of the first grade C lab, the one with the magic closed systems, in the Sawston facility. We will do, on FlaskWorks, what I've already said, which is finish the process. I've already described what that involves.
For the product release system that I described, to release a batch of product, just in terms of where we are with that . . so that was developed from scratch starting about 5 years ago. It was deployed in a pilot version in the small GMP lab in London several years ago. I believe, if I'm remembering correctly, it was about 3 years ago. And it went through a pilot testing period in the small GMP lab in the London facility. And then I believe about a year ago, if I'm remembering correctly, was, initially, it was installed on a pilot basis, in Sawston.
And now we have to go through all the usual steps. We have to go through the practice runs, it has to be optimized, we have to collect data, and so on. And we always have to show equivalency. Right? We have to show that the system produces an equivalent evaluation as the manual process by a QP, a qualified person. And again, this is another parallel track. This isn't, you know, off, you know, in the future, it'll be in parallel underway. Advent will be doing all of this, so fortunately, won't be us.
DCVax-Direct . . . very near and dear to our hearts. We have been eager to restart this program for a long time. And we, the first thing, of course, that we need to do, is restart the manufacturing. As it turns out . . . and this will be something that we'll make a public announcement when the time is right . . . anytime that you do a technology transfer process, because that product was only ever produced in the US, by parties who are no longer there, and so we had to do a technology transfer process to the Sawston facility.
Whenever you do a technology transfer process, you have to draft a whole new set of SOPs, (standard operating procedures), regulatory documents, all of that. And usually a technology transfer, especially for a cell therapy, is a minimum of at least 6 months of work. And then we've had two additional, challenges, which I think, we're on our way to having behind us. One that related to the machine that we use for the first stage of the process, and one which related to some key ingredients in the process. And when we come to that announcement, we'll we'll sort of explain all that.
But suffice it to say, restarting the manufacturing process, is a significant priority for us, in this going forward period, and you'll be hearing from us about that. And then once we've got the manufacturing restarted okay. Then we come to the last grouping of priorities. Once we have the manufacturing restarted, we are very eager to get the clinical trials underway to proceed. I guess, I don't know to what extent people remember, but the early stage trial that we did, was a phase 1 trial which, in which, it was conducted at MD Anderson.
We treated 13 different types of solid tumors, very diverse, pancreatic, breast, sarcoma, lung, colorectal. I mean, very diverse solid tumors, with very encouraging survival extensions in patients who were metastatic, and had failed every other treatment, and were pretty, pretty broken. DCVax-Direct. So that was really encouraging in the phase 1 trial. And even today, with all the billions that have been spent by the whole pharma and biotech industry on cancer treatments, when you have metastatic solid tumors today, there's not very much for you, as a patient.
And DCVax-Direct is a wonderful technology because it's directly injected into the tumor. The tumor that can't be surgically removed, either because there's too many of the tumors, or because it's located somewhere, where you might bleed out on the operating table, whatever, that are inoperable. But you, with image guidance, any form of image guidance, physician's choice, you can reach pretty much any location in the patient's body, to inject directly into the tumor. And even now, all these years later, we haven't seen, I'm not aware . . . maybe it's out there, but I'm not aware, we aren't aware . . . of any treatment like it, that's had the kind of encouraging results that the phase 1 trial did, and MD Anderson, in these patients. So we are very eager to get, get going again with that program. So that is, another priority.
We also, we have said, in all of our presentations about the results of our . . . now switching back to DCVax-L, lysate, for tumors that are operable . . . we have said, in all of our public presentations about the trial results, that this is very exciting to see the survival extensions with DCVax-L by itself, as a monotherapy, and version 1.0 of the DCVax-L technology, and that we are eager to build on that, with combinations of DCVAX L. And because DCVax-L has such a benign safety profile and because of what its mechanism of action, as a broad spectrum, we believe, that it will be eminently combinable with most other types of treatments.
You can imagine combining it with checkpoint inhibitor drugs, with targeted therapies, with chemotherapies, any variety of type of therapy. So we, we have some collaboration discussions underway, and at the appropriate time, because we only announce things when they're significant, and they're done. Right? We don't say, and that you know, giving our forward perspective, is quite unusual for us. But, anyway, again, these are forward looking statements. Everybody knows that. Right? Just reminding you again.
But we have said in every presentation, we are eager to combine DCVax-L with these other combinations. And so one of our many priorities, for the going forward period, is to do one or more of those combinations. And we've received considerable interest from various parties for that. So, we are looking forward to that. One thing I will say about our general approach, as we look forward on further clinical trials, is this: We want to focus particularly on clinical trials where tumor response, meaning tumor shrinkage, can be the endpoint as opposed to overall survival being the endpoint.
Why? Because, if you're going to see tumor shrinkage from a treatment, you can typically, potentially see it in a matter of months . . . and survival takes years and years. And we've just got done conducting one of the biggest, one of the longest, one of, you know, a real a major landmark in the field, in our opinion. But we would now like to do some more focused, faster path, tumor shrinkage endpoint trials. So we are, as we evaluate, I mean, we have so many opportunities in front of us now. Really, the challenge is choosing. Right? And so we we gotta steer ourselves, to the extent we can, towards that direction, to more shrinkage endpoints.
Two last points before we're done, done, done. Partnering. We've had some questions, various questions from shareholders. We're quite open to partnering. I've just I gave you a couple examples earlier of potential partnering, especially now that we have this tool chest of all these more technologies. But we're open to partnering. We'd like to be, where we see a partnering that could have either strategic value, or financial value, or both. And as we think about it, a partnering could be a regional partnering, geographic region. We have made a point of filing our IP and maintaining our IP in countries, wide range of countries. And we we try to build for the day when it would be, useful for that type of partnering, or it could be partnering for particular applications. So, we ,we will be open to that, and see what makes sense.
Last but not least, some folks have asked about uplisting. Certainly, everyone would love to be on a national exchange rather than the OTC, and we do realize, we do know that you guys are having difficulties, some of you, with the brokers, and they're making it difficult sometimes with our shares, while we're on the OTC. So we, we will be looking for when the strategic timing is right. We're not quite there yet, but we will be looking for that, so as we look at the going forward, period.
So let me close with just, a couple of concluding comments. First of all, I've I've tried to give you a flavor of a lot of different areas, without being here till next Tuesday. It's been longer than it was supposed to be. But all in all, I I have to say we've made, we feel, we've made tremendous progress in the last 18 months.
We're such a different company, further on company, than we were 18 months ago, and we're proud of that. And we hope that you are finding that exciting too. Second, comment is; there's no guarantees. I have to say this again, but we believe that we are well positioned to get a favorable result, and get our first approval, and begin commercialization. So that's all we can say is, we believe that we're well positioned, but, you know, and we'll all know, you know, reasonably soon.
We also believe that the infrastructure, and the systems that I've tried to give you a glimpse of without being too boring, that we've been working on these for years, in order to build for the day that's now arriving. Show that we have the physical facilities, and we also have the operating systems, and the strategies that can make this kind of a product, you know, can facilitate the commercialization. Also, we believe that at this point, with the careful in licensing, we've built a tool chest that has just tremendous growth opportunities to work with. I'll say again, we are painfully aware that the share price does not, at least currently, not yet, reflect this progress that we've made, that I'm describing. And I've said several times now repeatedly, we know how frustrating that is.
I will say, we believe, that if we can continue making progress in building actual value, intrinsic value, real value, and if we can continue taking action against parties, that we believe are artificially manipulating, and holding the shares down, and if we can work to attract some additional institutional investors, like our recent one, that we're very gratified, we think the combination of those things, building intrinsic value, fighting back against what we believe is manipulation, and attracting institutional investors, that ultimately the market will recognize the value. We know that we're not there yet.
And last of all, is what I get began with, which is we're so appreciative of all the votes that you guys cast. It was a phenomenal turnout, really impressive turnout, and we're so grateful for all the positive votes. And thank you. We're all done. I move that the meeting be adjourned.
Thanks, I thought senti might have posted one. I mean no offense to him, but ae might be one of the worst transcribers that I've seen.
Thanks ATLnsider, time to get the word out.
Has anyone posted a complete ASM transcript?
Thanks for the partial transcript senti. It can cause confusion when Linda (and Les last month) say that they believe that the MHRA is following the “150-day pathway,” which has now taken over 150 days since the application was submitted in December, and (I believe) validated in January. I think this simply means that they believe that the application is being processed on the MHRA’s accelerated pathway.
As a reminder, the MHRA created this new 150-day pathway in 2020 after BREXIT, with the intention to further accelerate the EMA’s accelerated assessment of 210 days. Unfortunately, COVID occurred at nearly the same time as BREXIT, which caused regulatory agencies to prioritize COVID treatments which, (along with staffing shortages) created a massive backlog that it has yet to fully recover from. Other than COVID treatments, no application has been processed even close to the 150-210 day timeline. Even though a serious effort to clear this backlog began last year, in January the backlog was over 1100 marketing applications, and it was still over 800 as of April. Last year, Dr. Hopper, the Deputy Director of Innovative Medicines at the MHRA, said that she hoped that timelines could return to 210 days this year.
As Linda described, it has been routine (and expected) to receive information requests from the MHRA during a very active back and forth with the agency during the application review. The company has been anticipating and answering these requests as promptly as possible to minimize any delay in the MHRA’s assessment. I don’t believe that Les or Linda have really tipped their hand to say exactly where Northwest Bio is in the review process; however, the discussion of inspections (and length of time since applying) indicates to me, that the MHRA is likely on the back half of assessment. Nothing that I’ve heard to date, has led me to change my prediction that an approval decision is most likely in the 3rd quarter, but the unknown seems to be the MHRA’s ability to process applications in a timely manner.
I’m not sure how it works senti, but survivin was discovered a couple decades ago, and has been targeted through various approaches in many clinical trials, but none have advanced due to minimal anti-tumor activity, or toxicity. That’s why I haven’t really dug into, or really worried about SurvaxM as a competitor while in early trials.
Can’t argue with most of that kab. And yes, the lack of communication from management is frustrating, but I understand, and tolerate it. As I’ve said before, I don’t expect that to improve while the majority of the shareholder base is retail, and the stock trades on the OTC. That type of information is provided to analysts during quarterly conference calls, so they can project revenues, and price targets for institutional investors, not to lowly retail investors.
I think you raise some valid points, but I don’t think any of this is unknown to Northwest Bio or Advent, and anything further that I would say will probably sound to you like “don’t worry, be happy” yet again, so I’ll spare you.
kab, Roswell Park and SurvaxM have been discussed a few times on the board in the past couple of years, but it’s usually when a naysayer brings up potential competition, so I was minimally aware of it. That’s right, their lead program is still in phase II for nGMB, so they are at least several difficult years behind Northwest Bio. Even if it is somehow approved one day, years from now, and somehow deemed different enough by regulators (not the same active pharmaceutical ingredient) to skirt Northwest Bio’s orphan exclusivity, they would have a difficult task to pull market share away from DCVax, the established standard of care that doctors will be far more familiar with. I haven’t been particularly worried about SurvaxM, but I’ve only looked into them superficially, and generally don’t worry about things in the future that may or may not happen, and are outside of my control.
It seemed to me that SurvaxM was created by a couple of doctors (not Dr. Kalinski) who formed a company, Mimimax, to commercialize it. So when I read the recent press release, I personally didn’t think that SurvaxM was a part of Northwest Bio’s exclusive agreement, but as I said before, there isn’t enough information provided in the press release to know which programs are included. And as you know, there are different types of exclusivity that can be carved up in different ways; for example territorial, like you posted. If and when more information is provided about the agreement, then I’ll probably dig more into those programs.
LOL. Thanks, that post has been stickied above since February.
beartrap, the press release didn’t give the details of which programs are exclusive, so I wouldn’t go so far as to say that Northwest Bio has bought and totally removed a competitor, but it could be considered more like Roswell Park is sharing some of their technology and knowledge only with Northwest Bio for now. Similar to what Northwest Bio did with Dr. Liau and some of her work at UCLA many years ago, Northwest Bio just did with Dr. Kalinski ’s work with the University of Pittsburgh and Roswell Park.
I haven’t had time, but others have probably dug into Dr. Kalinski’s dendritic cell programs, and discovered some interesting approaches for overcoming the tumor microenvironment’s resistance, and combinations with other agents to improve tumor infiltration for example, which would complement DCVax.
I’m pretty sure that during these protracted negotiations, there were discussions about each party’s patented technologies, and potential future violations, such as with Northwest Bio’s combination patents with checkpoint inhibitors, and I think this agreement probably helped to avoid some of that.
meirluc, the Leukopacks are the white blood cells from healthy donors, which would be used the same as the leukapheresis material from cancer patients in the Flaskworks system for the operational and performance qualifications of the flaskworks system, as well as the comparability study. New equipment, like the Flaskworks system, must be qualified before it can be used in a GMP facility. As a reminder:
During the equipment and facility qualification process, you should establish and provide documentary evidence of the following steps:
Design Qualification (DQ)
The intent of design qualification is to produce evidence that the equipment and the processes have been designed in accordance with the requirements of GMP, which include:
– Generation of user requirement specifications
– Verification that design meets relevant user requirement specifications.
– Supplier assessment /audits
– Challenge of the design by GMP review audits
– Product quality impact assessment
– Specifying validation documentation requirements from equipment suppliers
– Agreement with suppliers on the performance objectives
– Factory Acceptance Testing (FAT), Site Acceptance Testing (SAT) & commissioning procedures
– Defining construction and installation documentation to assist with Installation Qualification (IQ).
Installation Qualification (IQ)
The intent of installation qualification is to produce evidence that the equipment has been built and installed in compliance with their design specifications.
Installation qualification will provide you with documented evidence that the equipment or system has been developed, supplied, and installed in accordance with design drawings, the supplier’s recommendations, and In-house requirements.
Furthermore, installation qualification ensures that a record of the principal features of the equipment or system, as installed, is available and that it is supported by sufficient documentation to enable satisfactory operation, maintenance, and change control to be implemented.
Operational Qualification (OQ)
The intent of operational qualification is to produce evidence that the equipment operates in accordance with the design specifications.
The operational qualification will provide you with documented evidence that the equipment operates as intended throughout the specified design, operational, or approved acceptance range of the equipment, as applicable.
In cases where process steps are tested, a suitable placebo batch will be used to demonstrate equipment functionality.
All new equipment should be fully commissioned prior to commencing operational qualification to ensure that at a minimum the equipment is safe to operate. All mechanical assembly and pre-qualification checks have been completed, the equipment is fully functional and the documentation is complete.
Performance Qualification (PQ)
Performance qualification will provide you with documented evidence that the equipment can consistently achieve and maintain its performance specifications over a prolonged operating period at a defined operating point to produce a product of pre-determined quality.
The performance specification will reference process parameters, in-process, and product specifications.
Performance qualification requires three product batches to meet all acceptance criteria for in-process and product testing. For utility systems, performance qualification requires the utility medium to meet all specifications over a prolonged sampling period.
The performance qualification documentation should reference standard manufacturing procedures and batch records and describe the methodology of sampling and testing to be used.
kab, I can’t speak for the rest of the longs, but I for one, am quite confident that Northwest Bio will be able to raise whatever funds are necessary to support the initial commercialization, and their near-term development plans. The “market” as you say, currently is the OTC, which can be controlled and manipulated without significant capital, and made to appear as if there isn’t interest in this company. I don’t believe that to be true at all. There are in fact, some very astute investors and biotech companies out there who understand exactly what Northwest Bio is soon to be in possession of, which is a patent-protected, regulatory approved, cell therapy product, that can be mass produced, cost effectively, to treat a Glioblastoma cancer market that has relatively no competition. C’mon man, they’re sitting on a gold mine with proven assets. I don’t believe for a minute, that no one is going to lend them money to dig it out.
As I’ve said, I don’t anticipate that you will receive a satisfactory answer to your question, or that Northwest Bio will disclose in advance to this “market” how it intends to commercialize DCVax. Now, do I wish that events didn’t unfold the way they have, and Northwest Bio wasn’t on the OTC when all these announcements occur, so they would be fully appreciated, and valued appropriately in the “market?” Certainly, but that’s where they are right now, but I don’t think this is where they will remain, so I'm confident that one day, the true value will be realized one way or another.
meirluc, I personally don’t think actual patients are used for the Flaskworks development work. I thought they could have gone that route years ago, if they requested approval for the Flaskworks process for investigational use, but they didn’t. I think they are probably using a commercially available blood product like Leukopaks, for the Flaskworks qualification, process validation, and comparability studies. Although these products are from healthy volunteers, it’s acceptable to regulators.
Thoughts about the exclusive in-licensing deal . . .
Linda Powers continues to build long-term value for the company, even if it isn’t recognized immediately in the stock price (on the manipulated OTC). While it’s unclear (to me) exactly what Roswell Park’s intellectual property or programs are covered in this agreement, (or Dr. Pawel’s previous work at the University of Pittsburgh) what is clear, is that Northwest Bio (which has considerable dendritic cell expertise, and knows what to look for) has scanned the world searching for complementary, and potentially competing technology, and has found what it thinks is the most promising and advanced dendritic cell technology outside of the company, and licensed it . . . for a song. Northwest Bio has expanded and strengthened their dendritic cell therapy technology portfolio and has solidified their position as the world leader in dendritic cell therapy for the foreseeable future.
Northwest Bio has spent the past several years strengthening, preparing, and filing their marketing application, while also developing the Flaskworks automated manufacturing technology that will enable the large-scale production of dendritic cells for commercial use. This has put them years ahead of any other competing dendritic cell therapies (Provenge aside). In making this agreement, Roswell Park basically acknowledges that fact, and has ceded the ground. So what Northwest Bio has done with this in-licensing agreement is basically turned potentially competing technology, into a potential asset for Northwest Bio. Since some of this technology is already in phase II trials, if it succeeds and Northwest Bio is able to use this technology down the road, the development time required will be considerably reduced.
As Northwest Bio advances to the next stage of development, and begins collaborating and designing clinical trials for the next generation of DCVax products (and their combinations with other agents) with doctors Linda Liau, and Pawel Kalinski, who have been studying dendritic cell therapy and their interaction with the immune system for over 20 years, it will be certain that these products are going to be the state-of-the-art, and incorporate the vast knowledge gained by the foremost experts in the field. This deserves repeating . . . As Northwest Bio advances to the next stage of development, and begins collaborating and designing clinical trials for the next generation of DCVax products (and their combinations with other agents) with doctors Linda Liau, and Pawel Kalinski, who have been studying dendritic cell therapy and their interaction with the immune system for over 20 years, it will be certain that these products are going to be the state-of-the-art, and incorporate the vast knowledge gained by the foremost experts in the field.
This announcement also alludes to Northwest Bio’s future plans which not only include preparing to commercialize their first product, but what appears to be a fairly large development plan, with many clinical trials across both product lines, and potentially others. This obviously will require significant capital, so there clearly must also be a plan to raise what I would estimate to be a minimum of $150-200M. The other shoe yet to drop, is how they intend to do this. A regulatory approval (and pathway to revenues) will de-risk the stock, and potentially open access to institutional or partnership capital, which are the most obvious options, but there are others. Northwest Bio often seems to take the unconventional path and tends to surprise, so the real question for me is: What is the color of this elephant in the room?
I don’t expect to get an answer to this question at the up-coming shareholder meeting, but I do anticipate that we’ll get a little more color on this exclusive agreement.
You’re right kab, it’s complete bunk. I read that nonsense a while ago and dismissed it as more misinformation from a poster who seems to post as much misinformation (disguised as due diligence) as the naysayers. There certainly weren’t 200 compassionate use patients in 3 months last summer. I didn’t know where that came from until now, but undoubtedly, Les misspoke. Advent can’t even manufacture that many treatments in that period, even if they could find that many patients to pay themselves, which itself, is ridiculous.
While NWBO trades on the OTC, with only a retail shareholder base, I don’t anticipate more than the minimally required communication from management, as has been the norm. However, I do expect this to change when it’s a commercial enterprise and re-listed on a national exchange, which I think would likely involve new operational management, who must be accountable to institutional investors.
BTW kab, I’ve read a few of your recent posts and just want to say that I think you’ve been a voice of reason over the years and I have appreciated your posts. This message board has been degraded, and the Johnny-come-latelies have overtaken it. The sensible and informative posts seem to be a rarity these days, and there are only a handful of posters that I bother to read now, and you’re one.
Right, Dr. Bosch has discussed optimizing UCLA’s manufacturing process, that was used in Dr. Liau’s phase I trial, numerous times. In fact, there’s still a link to one of these presentations on NW Bio’s website, from the first Glioblastoma Drug Development Summit in 2019; slides 4 & 5:
First Clinical Trial
Dendritic Cell Vaccination in Glioblastoma Patients Induces Systemic and Intracranial T-cell Responses Modulated by the Local Central Nervous System Tumor Microenvironment
Autologous dendritic cells were pulsed with acid-eluted peptides from cultured autologous GBM cells to stimulate a class I – restricted CTL response
Survival data from this trial are highly encouraging
Linda Liau et al., Clin. Cancer Res. 11: 5552. 2005
Process Optimization
Initial assessment identified GBM as an interesting target but raised questions about scale-up of acid elution of cultured GBM cells
* Culture of autologous GBM cells often requires months of culture time to obtain sufficient numbers of cells
* Acid-elution process proved difficult to standardize
* Acid-elution resulted in cell death and release of a range of molecular species, varying in mass from small peptides to large macromolecules, with no identifiable peak at 9 amino acids
Use of tumor cell lysates developed as an alternative
* Avoids need for long-term culture as lysate can be generated directly from surgically resected tissue
* Range of molecular species is similar to acid-eluted material
flipper, there are different types of institutional investors, such as mutual funds, insurance companies, pension funds, endowment funds, sovereign wealth funds, and hedge funds, etc., that range in size from $ millions of assets under management, to trillions.
The larger funds have restrictions that don’t allow them to own small company stocks primarily due to inherent risk of small companies, the limited supply of stock, (and potential price imbalances) and limits in the allowable percentage of ownership.
Of that group, hedge funds are generally the smallest, and have far more freedom and discretion in their investment decisions. SIO Capital is a relatively small hedge fund, founded and run by a single Portfolio Manager (Dr. Michael Castor) who obviously isn’t limited by the investment restrictions, and bylaws of much larger firms. Of course, as an institutional investor, he and his team are required by law to conduct proper due diligence on any investment, because they manage other people’s money.
https://www.siocapital.com/our-team
Thanks senti, great synopsis. Of course some want the focus to be on the price that SIO Capital paid for their shares, rather than the fact that there is a new institutional investor in NWBO. I think the answer to Stillwell’s question, “Has the Tide Turned?” is definitely: YES!
This is a nice list of catalysts:
Catalysts
A. NWBO has submitted an application to the MHRA in the UK seeking marketing approval for its cancer fighting dendritic cell-based immunotherapy vaccine DCVax-L. A decision on approval is expected within a few months.
B. MHRA approval for NWBO’s Eden System which allows for automated production of its vaccine.
C. Announcement of new trials for other cancer indications both on its own and in combination with other companies.
D. Approval in other jurisdictions including Canada, the EU, and the U.S.
E. Progress in the lawsuit against several market makers including Citadel Securities and Virtu Financial for spoofing NWBO’s stock.
F. Potential up listing to a major exchange. Many institutional investors are prevented from investing in OTC stocks. An up listing following approval would create a whole new set of potential buyers.
Unfortunately, if you want to play in the ocean, you have to swim with sharks. I’ve discussed this same pattern here before that many others have probably noticed over the years. I have no doubt that Les “shops the deals,” and the word gets out. I think we can see what happens with that knowledge. And the trading pattern of the last couple of days also seemed to reflect knowledge that some sort of news was pending. It certainly isn’t a level playing field for market knowledge, or even deal making, for retail investors.
I’m sure it’s frustrating to Northwest Bio, as it is to all of us, but hopefully some of the funds behind this manipulative trading might be revealed during discovery if the court allows the case against the market makers to go forward. I think some of these funds act with impunity, because they’ve never really been held to account. Unfortunately, I suspect that some market makers may not be entirely forthcoming in the discovery process as we have seen in the Harrington Global case.
The US stock market (and the OTC in particular) is a cesspool hidden behind a thin veil of legitimacy; it’s rigged by sophisticated criminals, and “overseen” by an understaffed and compromised SEC and DOJ. And after the Gamestock fiasco, it was clear that our “blind” Congress unfortunately seems more interested in maintaining the stability of the precarious “financial system” than actually providing any teeth to the watchdogs.
Context is important ilovetech, and I recommend listening to the interview. They were talking about intellectual property protection and how cell therapy differs from small molecules in that regard; the idea that “the process is the product.” Of course you have to prove efficacy and safety to receive regulatory approval, but how to protect and differentiate a cell therapy product when there are literally dozens of companies approved and competing for a particular indication with basically the same product. If one is slightly more safe, or a little more effective, that might not be enough.
Gilead (Kite) was able to gain a first-mover advantage, which has allowed them to stay on top of those other CAR-T companies. But the ability to scale a product in the tens of thousands or more, cost effectively, and have that manufacturing process patented, (and be the first to do it) like say, Northwest Bio with Flaskworks. Now that is a way to truly separate yourself from the crowd, and dominate.
And BTW - you don’t license that manufacturing process out as skitahoe continually suggests might happen. That would be small potatoes, and won’t happen. You keep it tightly controlled, and continue to improve and patent that process, to maintain your superior position and dominance in the marketplace for your franchise. That’s how to build an empire. And Linda Powers knows this.
Thanks for the article ilovetech. It’s not a surprise to me that cell therapies haven’t really been particularly successful. From the article:
“From a commercial standpoint, the autologous products … just haven't really knocked the cover off the ball the way that people might have been hopeful, given how strong the clinical data were,” Schmidt said, speaking specifically to CD19 cell therapies, which include Gilead’s Tecartus, Yescarta and Kymriah and Bristol Myers Squibb’s Breyanzi.
Gilead has achieved the greatest success with Yescarta, which generated $380 million in net sales for the first quarter. Schmidt calls this the one “shining, positive example” in the field of approved therapies. The remaining approved cell therapies are all at or below $157 million.
Fulfilling the promise of cell & gene therapies through manufacturing (part 1)
“Our thinking needs to evolve so that we understand the rules of the game, the way we compete as therapy developers is changing. We’re starting with the same raw material that’s not protected, we potentially need to behave differently. One of the differentiators might not be safety, or efficacy. It might be viability. It might be the ability to supply the market, to supply patients, and payers, a cost effective product, and make it widely available, and some of those differentiators might be unique for this modality, versus where we’ve been historically with small molecules or biologics. “
attilathehunt, I personally think the MAA and ASM timelines are independent, but I can’t deny that it could potentially, “coincidentally” work out that way. If one were counting, 150 days from January 24th is Saturday June 22nd, (and CHM meetings on June 27th and 28th) which would be just before the ASM on Saturday, June 29th.
And speaking of coincidental date alignments; I’m not sure if anyone else noticed that there were CHM meetings held on April 25th and 26th, and there was this, Entry into a Material Definitive Agreement: (which may have been a positive signal of a go ahead)
Loan Entered Into
On April 26, 2024, Northwest Biotherapeutics, Inc. (the “Company”) entered into a Commercial Loan Agreement and Note (collectively, the “Loan Agreement”) with Streeterville Capital, LLC (the “Holder”) in the amount of $11,005,000. The Loan Agreement has a maturity of 22 months. Repayments do not start until December 26, 2024.
The funds will be used for the Company’s ongoing business operations, including beginning initial construction works for the first grade C lab in the Company’s Sawston, UK facility, ordering certain initial long lead-time equipment for the first grade C lab, and facility preparations for delivery of the initial GMP units of the Flaskworks system.
https://www.sec.gov/ix?doc=/Archives/edgar/data/0001072379/000110465924056424/tm2413348d1_8k.htm
Lykiri, thanks for the thoughtful post. I agree that it’s likely that Northwest Bio’s marketing application was high quality, and did not require additional information to be requested from the MHRA, as stated in the 1st quarter report. I also agree that it is highly likely that the application has received priority review.
I personally don’t believe that we can deduce the exact timing of the final decision by the timing of the ASM, or anything that Les said, since the company will only have a general idea of where the MHRA is in the process (and because Les has not exactly been reliable about timing). It appears to me that they have passed the first assessment phase and are now somewhere in the second phase, but it is difficult to know how long this phase will take with the backlog of inspections, and understaffed inspectors at the MHRA. I say this because Les said that no negative disclosures were required in the quarterly report, and he was talking about scheduling site visits, which generally occur after the initial scientific assessment. The company may also be able to deduce where the MHRA is in the process, if their questions change from questions about the application itself, to questions about defining the label, (whether enough evidence was presented for the label to be broad - for all gliomas, or simply for nGBM and rGBM) and post-approval risk management plans, etc.
It seems somewhat irrelevant (to me) to be trying to determine exactly when the assessment started, and counting days in the 150-day assessment timeline when the MHRA hasn’t been close to completing a single assessment in this timeline that was established four years ago. Having said that - I personally don’t know what the second validation date of March 7th means, but I believe that it was determined on or by that date, that the application was complete, and of high quality, so no further information will be officially requested by the MHRA, and the application is entitled and “confirmed” to receive priority review.
I think that, for the purposes of the MHRA’s own timeline, (since they track this) the official assessment (and timeclock) started at the first MHRA validation date of January 24th. I believe that they intend to complete the assessment as soon as they can, but with backlogs, it may take more than 150 days. However, I’ve always hoped the MHRA could pull a rabbit out of its hat for Northwest Bio.
Thanks for the advice ATLnsider. I read some of bio’s responses to you on this subject a couple years ago, which in my view, seemed rather dismissive and condescending. There certainly is some basis to the theory of using poly I:C in the manufacturing process of DCVax-Direct at least, and potentially even for DCVax-L down the road.
I agree that poly I:C was not used as an activation agent in the first clinical trial with DCVax-Direct, (it was BCG and IFNy). However, I think many other agents, including poly I:C, were also studied by Northwest Bio in earlier, pre-clinical work with Direct. I speculate that because of the UCLA studies, and the impressive results seen with poly-ICLC in combination with DCVax-L, and a potential in-licensing agreement with Oncovir, that poly I:C could be further studied as a activation/maturation agent in the manufacturing process for DCVax-Direct going forward. As I said in my previous post to you, using poly-ICLC in the manufacturing process for DCVax-L is far more difficult due to the culturing method used for DCVax-L, but I think it’s at least potentially possible. I do agree with you that the combination of DCVax-L and poly-ICLC is the plan going forward for all current and future studies of DCVax-L, but I think it will be administered as separate injections for now.
Some people are unwilling to go out on a limb and potentially be wrong because they always have to be right, so I appreciate reading your (and other’s) reasonable speculation and research that may be out of the box, even if it’s not always correct. I also respect bio and agree with most of his posts, and I appreciate his arguments against the naysayer’s false claims over the years, which have since been proven false and irrelevant as clinical trial results were published, and the marketing application finally submitted. I generally don’t put longs on ignore, but simply don’t read their posts, and I rarely read his posts these days, or reply to him, but that post caught my attention.
bio, thanks for the clarification. I think a lot of misunderstanding and misinterpretation can happen on these message boards because full thoughts are often abbreviated, context is missing, or all mashed up as ae Kusterer does. I don’t read his posts so I didn’t realize (but probably should have) that he Frankensteined my post onto others.
bio, the poster that you responded to was ae kusterer, who we all know, reposts other people posts without good reference. It was my post that he reposted, which I also put in my response to you as reference. You basically claimed in your response to him that part of my theory, which states that poly I:C could be used as a maturation /activation agent for DCVax-Direct was a false theory with no basis.
In the part of your post that I bolded, you said that poly-ICLC can’t be used as a maturation agent, or used in the manufacture of any DCVax product including Direct, and that it can only be administered separately as an adjuvant. That is false and you are wrong, as I just showed in Northwest Bio’s patent. I’ve seen you twist an argument, and go off on tangents, to make it seem like you were not wrong many times, just as you are doing here. This is exactly why I said that I don’t want to waste my time on this.
Really bio? You respond to ae kusterer, but not to my original post?
Poly-ICLC is a different company's DRUG. Not part of any natural dendritic cell maturation process. It works by pretending to be a VIRUS and stimulating other processes in the body when DCVax-L is injected. The entire notion is incorrect, and as I said, it is not in that particular patent that was referenced in the post to which I just previously referred. It's not included in any version of DCVax, either Direct or DCVax-L It's another company's carefully created, manufactured, drug and NWBO did not have a patent to make it any more than they had a patent to make Keytruda. They also have never claimed they make it nor that they sourced it from Uncover for their manufacturing.
I too, hope they coordinate and present trials with the combination in the future. The results are wonderful. But sometimes people make things up because they want to believe something. They get it in their head. Poly-ICLC is an adjuvant treatment in all of the trials. It is injected separately in an intramuscular injection. The UCLA formula for ATL-DC and DCVax-L are the same. There is no disconnection, as has been claimed by some shorts and so there is no need to further promote this false theory that will only create confusion as there is simply no basis to it.
OPTIMALLY ACTIVATED DENDRITIC CELLS THAT INDUCE AN IMPROVED OR INCREASED ANTI-TUMOR IMMUNE RESPONSE
One method to overcome this down regulation has been disclosed in WO 2004/053072 (incorporated herein by reference) where it was found that down regulation can be avoided through partial maturation of the DCs prior to administration. In this method dendritic cell precursors (bone marrow cells following red cell lysis or monocytic dendritic cell precursors) were induced in vitro to differentiate into immature dendritic cells and the immature dendritic cells were induced to begin maturation by culturing the cells with a dendritic cell maturation agent, such as BCG and IFN?, lipopolysaccharide (LPS), tumor necrosis factor a (TNFa), an imidazoquinoline compound, a synthetic double stranded polyribonucleotide, a agonist of a Toll-like receptor (TLR), a sequence of nucleic acids containing unmethylated CpG motifs known to induce the maturation of DC, or any combination thereof. The immature dendritic cells were allowed to continue maturation for a time period less than what had previously been determined for the immature dendritic cells to fully mature. If the dendritic cells were allowed to fully mature in vitro the cells would be unable to uptake and process antigen subsequent to administration to the patient. The inventors disclosed that the dendritic cells should be allowed to mature for 1 to about 10 hours for optimal activation prior to isolation of the partially mature dendritic cells and formulation for administration to a patient.
In the methods the dendritic cell maturation agent can be inactivated Bacillus Calmette-Guerin (BCG), interferon ? (IFN?), lipopolysaccharide (LPS), tumor necrosis factor a (TNFa), an imidazoquinoline compound, a synthetic double stranded polyribonucleotide, for example, poly I:C, a agonist of a Toll-like receptor (TLR), a sequence of nucleic acids containing unmethylated CpG motifs known to induce the maturation of dendritic cells, or any combination thereof. The inactivated BCG can comprise whole BCG, cell wall constituents of BCG, BCG-derived lipoarabidomannans, or BCG components and the inactivated BCG can be heat-inactivated, formalin-treated, heat-inactivated and formalin treated, and the like.
Claims
8. The method according to any one of claims 1 and 2, wherein the dendritic cell maturation agent is inactivated Bacillus Calmette-Guerin (BCG), interferon ? (IFN?), lipopolysaccharide (LPS), tumor necrosis factor a (TNFa), an imidazoquinoline compound, a synthetic double stranded polyribonucleotide, a agonist of a Toll-like receptor (TLR), a sequence of nucleic acids containing unmethylated CpG motifs known to induce the maturation of dendritic cells, or any combination thereof.
14. The method according to claim 8, wherein the synthetic double stranded polyribonucleotide is poly I:C.
https://patents.justia.com/patent/20180187145
Doc, I personally don’t think the MHRA will inspect Charles River Labs' (formerly Cognate’s) or Fraunhofer’s manufacturing facilities, since they are not currently being used (or immediately planned) for initial DCVax commercial production.
I think, but I’m not sure if the MHRA is like the FDA, in that they will generally schedule a pre-license or pre-approval inspection of the intended commercial manufacturing facility after the midpoint in the review process, and request to view all phases of the production operations for the selected product under review in the marketing application.
Shutting down operations of a GMP facility for construction, maintenance, cleaning, and disinfection is complex, but routine, and would not effect anything unless a significant change to the plant and equipment occurs, which would usually require requalification. (except that a pre-approval inspection obviously could not be scheduled during the shutdown)
ski, are you asking if I think the UK inspectors need to look at the manufacturing sites used for the clinical trial, since only Sawston is indicated for commercial manufacturing at this time?
If so, my answer is no, it shouldn’t be necessary as long as there were no potential red flags raised during the review of the clinical trial patient records or manufacturing records from those sites that were sampled. However, that may not be the case, and not all inspectors/regulators are equally thorough, or think the same. Generally, the first marketing application and regulatory review for a new drug, or molecular entity, is more thorough and takes longer than subsequent marketing applications for additional use of an already approved drug. (since the appropriate nonclinical and manufacturing data may have already been reviewed by the Agency in the initial application)
Visits to potentially obsolete manufacturing sites is certainly one area of the 150-day accelerated review process that could, and probably will be cut to expedite the review from the standard timeline. As additional commercial manufacturing sites are added, they may be inspected at that time.
Right ATLnsider, as you indicate, in the UCLA combination studies with DCVax-L, the poly-ICLC is administered separately as an adjuvant. However, in the early studies with DCVax-Direct, it was used in the manufacturing process, which increased the potency. (poly I:C, or its derivative, poly-ICLC is included in the Direct patents, and the more recent hyperactive patents)
NW Bio Receives U.S. Patent On Broad Processes For Producing More Potent Dendritic Cells
Next Generation Technology Already In DCVax®-Direct; Will Be Applicable To All DCVax® Products
Building upon the pure immature dendritic cells, NW Bio's patented methods develop mature and activated dendritic cells that are far more potent than dendritic cells produced in the standard way. For example, NW Bio's dendritic cells produce as much as 10X or more the amount of signaling compounds which are key to mobilizing other active agents of the immune system, such as T cells (which infiltrate and attack tumors) and B cells (which produce antibodies).
NW Bio is already using these next generation methods for producing more potent dendritic cells in its production of DCVax-Direct. The same patented methods for activating dendritic cells were also used in the pre-clinical animal studies with DCVax-Direct. In those studies, injection of these potent dendritic cells into some of the tumors in each of the animals resulted in complete clearance of all tumors (both the tumors injected with DCVax-Direct and the tumors not injected) in 80-100% of the animals in the various studies, indicating a system-wide immune response.
?
Going forward, NW Bio's now patented methods of producing more potent dendritic cells will also enable development of the next generation of NW Bio's other two product lines: DCVax-L and DCVax-Prostate. The current DCVax-L and DCVax-Prostate products have already delivered striking results in clinical trials to date, extending the time to tumor recurrence and the patients' survival time by 1-1/2 to 2 years or more, with a substantial portion of patients going far beyond that. Incorporating NW Bio's patented methods for more potent dendritic cells will enable production of enhanced versions of these DCVax-L and DCVax-Prostate products.
https://www.prnewswire.com/news-releases/nw-bio-receives-us-patent-on-broad-processes-for-producing-more-potent-dendritic-cells-198760831.html
ski, the pre-approval inspection is performed to assure regulatory authorities that the facility listed in the marketing application can manufacture the product, and that the data submitted is accurate and complete. Regulators will look to confirm that:
* The site conforms to the application
* The site demonstrates manufacturing reliability
* The site can scale its operations
* The site uses suitable and adequate analytical methodologies
* The site is producing authentic and accurate data
* The site is in full CGMP compliance
I have full confidence that the Sawston facility will pass the inspection as they have previously, regardless whether it’s the same inspectors or not. Although it’s probably the most important, Sawston may not be the only site visited, since other manufacturing sites were used for the clinical trials. (Cognate in Memphis, and Fraunhofer IZI in Germany) Obviously those other sites haven’t manufactured a product for Northwest Bio in a decade, but scheduling these visits in a timely manner could be more of an issue in my mind, and it seems impossible to predict if they even will, or the timing.
Thanks for the clarification ATLnsider, and apologies that I got it a bit wrong.
Yes hank, the "manufacturing and clinical trial site visits" are the inspections that are referenced on page 23 of the recent 10Q. And yes, I think they are intended to be completed within the second 70 assessment period, however, as I included in my post, the MHRA is still backlogged and may not be able to complete this in the 150-day assessment timeline as intended. They are potentially all clinical trial sites and manufacturing sites directly related to the clinical trial and the MAA, as well as any current manufacturing sites (Sawston) that will be used for commercial production, and not the Eden Flaskworks system, which I believe is separate from the MAA.
I don’t think it’s opposite things flipper. As I said here, the marketing application review is an interactive process where the company is sharing requested information with the various assessors and inspectors, and I think this process is what Northwest Bio spent months preparing for, and discussed in their press release. But because Northwest Bio used the language “request for further information” in the following press release, I believe that some may have misconstrued this process with an official RFI letter, which is sent to the company after the first phase of scientific assessment, if more information is needed that is not included in the marketing application and supporting documents.
For the GBM MAA, the Company anticipates that the review process will be a period of intensive and extensive further work involving responding to questions and requests for further information by the regulatory authority as well as preparing for and undergoing detailed inspections of the contract research organizations (CROs) that managed the trial, the Sponsor, the Trial Master File, a number of individual trial sites selected by the regulator from among the 94 sites that participated in the trial, the GMP facility and manufacturing information.
https://nwbio.com/northwest-biotherapeutics-announces-marketing-authorization-applications-submitted-uk-mhra-dcvax-l-glioblastoma/
beartrap, to market a new drug or biologic, regulations require adequate and well-controlled studies that distinguish the effect of a drug from other influences. And for regulatory approval of combination regimens, it is necessary to demonstrate the contribution effect of each monotherapy to the overall combination. This is why I believe that Northwest Bio’s first marketing application did not include other adjuvants.
ATLnsider has speculated that Northwest Bio is using poly-ICLC as a maturation and activation agent in the manufacturing process of DCVax-L and therefore, thinks it will be included in the marketing application. While I believe this manufacturing method may have been studied, I believe it was with DCVax-Direct, and not DCVax-L. Northwest Bio did not use this manufacturing method for the clinical trials with DCVax-L, so I do not believe the first marketing application includes poly-ICLC as a maturation/activation agent either.
As I’ve said, other than a few potential anecdotal cases, I don’t think Northwest Bio has enough (real-world) data to seek regulatory approval with Poly-ICLC at this time. I’m not aware of ANY actual evidence that studies with a significant number of patients were performed using this combination (or manufacturing method) for compassionate use, so this seems to be complete speculation. As far as Dr. Ashkan using it for compassionate use and collecting real-world data; I’ve seen a number his presentations about DCVax, and not once was poly-ICLC mentioned. The only data that I’m aware of with poly-ICLC, is the UCLA data, which I believe Northwest Bio intends to confirm through their own clinical studies,(both DCVax-L and Direct) as soon as possible. (after the first regulatory approval and in-licensing agreements are finalized) They might even run studies to determine the optimal method of combining poly-ICLC with DCVax; as a separate adjuvant, or as a maturation/activation agent in the manufacturing process.
BTW - I’ve read some of dstock’s posts, and in my opinion, his speculation seems rather far-fetched and not based in reality. For example, I don’t believe Merck or any Big Pharma company (except NW Bio’s CDMO, Advent) is constructing a manufacturing facility to manufacture DCVax, nor did Merck and Northwest Bio secretly run the combination trial for colorectal cancer. I highly doubt that any Big Pharma companies are currently hiring positions related to Northwest Bio, nor do I think that Northwest Bio is secretly applying for approval with poly-ICLC. Everyone is free to speculate and believe whatever they wish, so I mean no disrespect, but I’m just stating my personal opinion on this because you asked.
I think the extremely slow pace of DCVax development, and lack of communication, has led many of us to speculate that certain developments have occurred or could be happening behind the scenes. This very rarely proves true, and in most cases, Northwest Bio at least mentions, or alludes to their development plans in SEC filings or press releases, and announces significant milestones when they are achieved.
I think the 1st quarter 10Q was positive, and nothing in it has changed my opinion that the timing of marketing approval seems most likely in the 3rd quarter. It reads as though the application was complete, and there was not a request for further information after the first phase of assessment. Just like the application itself, Northwest Bio also seems well prepared for the manufacturing and clinical trial site visits that occur in the second phase of assessment.
Despite requesting a 150-day accelerated approval pathway, and being fully prepared for the rigors of assessment, Northwest Bio is not in control of the timing of the process. The most recent MHRA Performance metrics indicate that the MHRA is still considerably backlogged, even though they hired a number of new assessors last spring and summer, and hired a number of new inspectors late in the fall, and continue to hire inspectors currently.
Assessment of New Marketing Authorisation Applications and Variations April 2024
Validation for new MAAs – all submission routes
Average time to validation in days: 7
Numbers validated: 72
% validated within statutory time: 92
Work on hand
Overdue individual Product Licences from backlog of 1167 at 9 Jan 2024 (past the 210 days) as at 30 April 2024: 805 ****
**** Overdue individual Product licences (past the 210) days shows all pending abridged (biologicals removed) national licences (with current clock on or off) with regulatory clock on days over 210
https://assets.publishing.service.gov.uk/media/6644a44bbd01f5ed32793bdf/MHRA-Performance-Metrics_MAA-V_2301-2404.pdf
Beartrap, you can be certain that one of the in-licensing deals that Northwest Bio has been negotiating, is with Oncovir for Hiltonol (poly-ICLC). We’ve discussed before about Northwest Bio’s patents and plans for a 10x more potent form of DCVax-L, which is the combination with poly-ICLC. This is the next generation of DCVax that Northwest Bio discussed in the 10k, and other filings.
I think it’s also very likely that another in-licensing deal is with Daiichi Sankyo for Pexidartinib (CSF1R inhibitor). These are the adjuvants that Dr. Liau has trialed at UCLA, which have shown tremendous results. Northwest Bio added Dr. Liau to the Scientific Advisory Board to assist with these registrational trials, and I think they will begin as soon as possible.
What is not very likely however, is that the marketing application that has been submitted to the MHRA includes either of these adjuvants. I’m firmly in the camp that says Northwest Bio will need to first receive approval for DCVax-L as a mono therapy added to the current standard of care. I also don’t believe that Northwest Bio has enough data to seek regulatory approval for the combination with poly-ICLC at this time, but I think it’s certainly in their near-term plans. (They may use the new standard of care, which includes DCVax-L, as the comparator arm)
Really Doc? A thousand patients a month? Could you define the timeframe of “about ready?”
That’s about 33 batches a day. Do you understand what that would require? How many Flaskworks systems, Qualified Persons, etc.?
beartrap, that’s the hard part. When is “close to approval?” I don’t think compassionate-use patients or Northwest Bio will actually know when marketing approval is coming, until the day the decision is made, so it may become increasingly difficult for those patients to decide whether to pay themselves and begin treatment in the coming months, knowing that marketing approval could be coming any day.
I do think the health ministers at the NHS understand the desperate situation that glioblastoma patients would be in, if compassionate use is no longer allowed, when DCVax receives a commercial license, especially if a decision from NICE doesn’t follow rapidly. And I agree that there will certainly be pressure to act on cancer patient’s behalf, if that’s what you meant by being “forced.” It seems reasonable to think that a funding source like the Cancer Drug Fund could be used to help some patients, and this would allow Northwest Bio to cover the manufacturing costs in the interim period between commercial approval, and a NICE reimbursement decision.
When DCVax receives reimbursement, I think they could continue to manufacture using the manual method in a limited capacity until the automated Flaskworks process is approved. Northwest Bio has always put the patients first, so of course they would continue to make the treatment available, but I personally don’t see large scale manual manufacturing initially as you are suggesting could happen with patients flooding in, but who knows.