NorthWest Biotherapeutics Inc (NWBO)

[HappyLibrarian]

DCVax L is an older technology, and almost certainly a less effective treatment than DCVax Direct, though it is still ahead of SOC. That's just reality.


I have sometimes thought that NWBO delayed the completion of the Phase 3 trial by a year to buy more time for Direct results to become public. In this way, if the blinded DCVax L trial were to produce less than stellar results, Ms. Powers could point to the great results of DCVax Direct in the Phase 1 and maybe hurry up the release of some Phase 2 results.

Do I think that's likely? No. But possible? Yes.

Here's the key difference as I understand it, explained in very crude terms:

DCVax L:

DCVax L is made from the lysate sampled from a tumor one time and then a bunch of canned doses are created that can be used for months and years of treatments.

The canned doses are great but they have a downside: whatever antigens they target are what they target and that's it.

That means that if the remaining tumor cells left behind after the surgery can survive long enough, they might be able to evolve to stop expressing the antigens DCVax L picked up from the lysate.

Thus, over time, DCVax L would become less effective if it fails to eradicate the remaining tumor cells.

Still DCVax L is a hell of a lot better than the other options patients with GBM have right now. And nat

Plus, if the tumor comes back, there's nothing that says you can't debulk it again, grab the lysate and generate a new batch that matches the evolved tumor cells.


DCVax Direct:

Because Direct consists of DC cells that are put directly in the tumor
they start from scratch in picking up the antigens each time they are injected.

In theory Direct can adapt to the tumors as they evolve provided you just keep injecting.

Since tumors can be different genetically even within the same patient, this shows the value of injecting multiple tumors more often instead of one tumor infrequently.

Deprived of tumors ability to mutate away from expressing the antigens DCVax Direct is targeting, the tumors exposed to DCVax Direct should be easier to dispatch and keep dead than those treated with DCVax L.