Maybe such a combo trial alone would not be enough reason to get super excited, if trial data from the DCVax's didn't strongly suggest that often a strong immune response does get generated as a result of DCVax, but it sometimes blocked by the Immune Blockade functions. An immune response that was not generated by the body alone, without DCVax. But the trial data does suggest this. See Dr. Prins video.
As monotherapies, the blockade inhibitors (BI's) have horrible side effects at the dosages needed to be effective. These side effects occur in about 25% of patients, which is about the same number of patients where they are strongly effective. This makes them a miracle drug for patients who's chances of remission were very low, ie much lower than 25% without the BI's, but it makes them inappropriate for many other patients. If the DCVax's do generate a strong immune response, as data presented shows, then this might allow the use of a smaller dose of BI's in combo trials. Maybe a small enough dose to reduce the number of side effects, yet with synergy, increase the efficacy. This is the hope, and it is totally rational to estimate the chances that such will prove out are high.
DCVax-L and DCVax-Direct are two of only a few therapies that generate T-Cell responses targeting neoantigens. These few therapies may prove to be the only cost effective therapies that accomplish this critical task. There are "T-Cell" therapies that do this by extracting and replicating T-Cells from tumors, but those therapies are substantially more expensive than the projected cost for DCVax-L, and much much more expensive than the projected cost for DCVax-Direct.
There is every reason to believe that the chances are high that the combination of DCVax-Direct and a BI will prove to be the next miracle cancer cure, with the most recent being the BI's themselves, and perhaps the individualized T-Cell therapies. DCVax-L may prove as effective or more effective as part of the combination therapy, but the cost is not fully known, though again, I believe it is safe to estimate the cost to be much lower than for the T-Cell therapies.
One of the concerns about the performance of the DCVax's is crowding in the DC pathways and lymph nodes due to the very large number of DC's created that carry self-antigens for every neoantigen for presentation to the T-Cells in the lymph nodes. But DCVax-Direct DC's are not injected in the skin near a lymph node or a few lymph nodes. They are free to travel from the tumor along whatever path they chose. They likely distribute widely, and might distribute relatively uniformly to all of the 500 lymph nodes in the body. That is a huge amount of reduction in crowding for each pathway and each lymph node. Further, the mfg process for the DC's for DCVax-Direct was already relatively inexpensive, prior to recently being automated. Unless you believe the unlikely allegations that the DC's don't survive the freeze thaw, you may have a limited time to get your butt out of shortsville.
