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Thursday, June 06, 2019 12:00:28 PM
Gunjur is one of the papers referenced by NWBO in the AACR abstract for the Info Arm.
Ah, okay, I remember the Abstract well (and your's and my discussion over the mean versus the median).
I get that some pseudo progression patients will not live into the 3 and 7 year ranges.
Two things... first, the indeterminate group is really comprised of either early or pseudo progression patients. So when comparing against Gunjur's Fig. 3, the middle curve (the red curve, the noPD group) is not relevant. That leaves us with the psPD and ePD curves.
So the psPD curve shows that out out 14 psPD patients, 3 had passed by 12 months - 21%.
With the ePD curve, 18 of 27 patients had passed by 12 months - 66%.
With the Information Arm, the separation between the 15th patient and the 16th patient seems pretty clear to me, with the majority of the first 15 patients clustered pretty tightly. The first 5 had passed by 5 months, the next 3 by 17 months, and the final 6 months by about 20 months.
The entire group of them were all thought to be rapid progressors ... initially. But I think it's become more obvious that some of them were psPD, as you'd suggested back in 2014. I also think it could also be argued that they really were all ePD and that some just reacted better to DCVax than others... maybe they were mesenchymal. But with LL having now stated that they were all psPD (mistakenly), when she initially thought they were all ePD makes me think I'll just look t the curve myself, for now, and see what I think. Let's remember, she let slip the means versus the median, so mistakes get made. Anyhow, I think my assessment is fair, and given that none of us know what the MRIs and blood panels for these patients showed (and LL and Dr. B have not shared those with us either), then I'll stick with the fact that because this group was indeterminate, it's likely to be comprised of both ePD and psPD.
And if you consider that the first 15 were likely rapid progression patients, and that 5 of the 15 had died by 12 months, that's 33% of that group; and then consider that 8 of them had passed by 15 months or 53% of that group of 15, I'd suggest then that this group of 15 (whom I think were definitive early progressors) performed slightly better than the group you cited (Gunjur - who's chart showed 66% had passed by 12 months). Why might that be? Because the information arm patients all immediately started on DCVax the moment they were disqualified for the main arm of the trial, whereas Gunjur's group of ePD did not get the added benefit of DCVax.
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