Friday, June 14, 2019 12:35:54 PM
Just to be blunt, I don't think Dr. Liau would be as attuned to what was likely happening to separation once the trial left the confines of UCLA despite the fact that she is the principal investigator in the United States, and she would have, imo, less chance/info to opine on any possible separation once the trial moved overseas. Hence why I think Dr. Ashkan in the UK was so excited, and why the trial likely finally stopped adding placebos in Germany, imo. (Note: The UK started enrollment with German made DCVax-L in 2013, and Germany started enrollment in 2014)
5-ala surgery can reduce tumor cell count further than normal surgery. Dr. Liau, as you are aware, and Dr. Bosch for that matter, clearly realize DCVax-L is not able to keep up with the tumor in most cases where the tumor has reorganized and is doubling in size at very frequent rates.
I do believe Dr. Liau's talk about treatment now versus treatment later is specifically designed to (ethically) sandbag all of us, longs, shorts, etc, into a more conservative expectation. I personally do not buy this reason for a conservative expectation, because I personally do believe DCVax-L does not typically help much after recurrence without surgery combined with DCVax-L. We know that only three such combinations occurred as of the March 2017 data. Anything after that would have been on patients in the trial with much later recurrence.
In other words, while I can totally appreciate Dr. Liau's low balling conservative approach to discussing the trial, it is one place I diverge from her conservative view. If the trial fails, I agree with her that it may be due to timing, or needing to use combinations in the future with DCVax-L, etc, but I do not believe survival treatment failure to separate from placebo would be due to crossover, because I think the lack of second surgeries eliminated this as a significant obstacle.
Likewise, for the same reasons, if DCVax-L succeeds, I don't think it would have done much better with survival if there had not been a crossover. Although I am certain my then conservative voice on this would be completely drowned out in the event of trial success.
Respect Risk. Conduct Your Own Due Diligence. Manage your assets wisely. Diversify.
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