NorthWest Biotherapeutics Inc (NWBO)

[AVII77]

RKMatters, I think I figured it out.

You may not believe it, but I try very hard to understand different points of view. I truly struggled to try to see why, something that is clear to me, is not recognized by you. Your last post gave me an important insight.

This is where I believe your thinking went astray:

You stress all this TTT (Time to Treatment) stuff. That was my clue.

What you don't appreciate is that for an autologous vaccine, surgery is an integral part of the "treatment".

That is why, uniformly, ALL autologous vaccine (single arm) trials measure efficacy from the time of surgery as their starting point.

So, for DCVax, surgery is an integral part of the treatment strategy (you must obtain tumor to make the vaccine).

If they measured the efficacy of this treatment strategy starting AFTER surgery, we would ignore the competing risk of death from the surgery itself.

That would not provide a meaningful estimate of the treatment strategy.

Take an extreme example, suppose 50% of rGBM patients died from surgery to obtain tumor but DCVax cured all of those who survived to receive treatment?

What is the REAL efficacy of the treatment strategy for a rGBM patient? Ignoring that surgery starting time point would grossly overestimate the benefit of the intervention in that extreme example (100% cured vs 50% cured).

And that is why they measured efficacy from surgery.