AVII77 and flipper44,
I have been spending time this evening trying to catch up on all the recent comments and something big is being hinted at here I think. Just for clarification, in the past TILs meant tumor infiltrating lymphocytes which often focused on T-cells and B cells amongst others. Now this terminology (TILs) mostly refers to tumor infiltrating lysate if I read the posts properly from the report. This would indicate to me that there may be some cross referencing going on here. Infiltrating lysate would obviously be in the form of activated DCs. The measure of pre-treatment TILs seems to be a reference to DCs trying to become activated by naturally ocurring in vivo lysing and perhaps the presence of other lymphocytes as well. This language appears to be pointing out or perhaps even bordering on attempting to confirm what was noted in the Direct trial about patients with a certain type of DC population prior to treatment having better outcomes. The other hint in all of this is that improved DC migration matters and this relates to the low dose, multiple injection site protocol being used for the Phase 3 trial which was not used in the earlier trials referenced. The reason patients might all be living longer is that the obvious best options for patients with regard to observed synergies between potential additional resection, Temodar, DCVax and checkpoint inhibitors can be used at crossover. Treatment patients have the potential initial benefit of chemo/radiation plus improved dosing regimen as well as the added dosing and same options at recurrence as SOC vs what patients from earlier trials had.
The take away here for me seems to be that DC activation subtype as well as dosing and synergy from options available at crossover are making a big difference from what has been seen in previous trials.
