In thinking about cancer treatment and our vaccines, if a patient had an operable tumor, wouldn't it still be ideal to create DCVax-Direct and inject that tumor prior to operating and allow the vaccine to permeate the tumor. Then on operating, use the removed mass to make DCVax-L for follow on treatment.
My thinking is that if 99% of the tumor was removed, that remaining 1% could be found in numerous places, and it can grow in each of these locations. If everywhere it can be found it also has DCVax-Direct working against it, its growth is likely to be stunted, then you add DCVax-L created from the tumor and you may have a knock-out punch.
I know that currently Direct is only used with inoperable tumors, and that's a good start, but if what I'm suggesting makes sense, it could be created and used before operable tumors were removed.
We all tend to think that discovery of a cancer should result in almost immediate removal of it. In practical life this doesn't happen, it often takes weeks to months before surgery, sometimes there is pretreatment, sometimes no. In some cases, chemo must be used to shrink the tumor to a size that permits surgery. I don't know that Direct would replace the chemo, or supplement it, but other than cost, I don't see a down side to such treatment, and if it's more effective in using it in this manner, the overall cost would be lessened, even if up front costs before surgery is greater.
I believe that Insurance companies often cost themselves more money by authorizing lesser treatment up front. Where a more expensive treatment is likely to resolve a problem, the use of something cheaper that fails to resolve the problem results in significantly higher costs over time. I realize that trials would have to determine that what I'm suggesting is true, but if they did, or once approved if anecdotal evidence showed that to be the case, it would be foolish not to spend the money in this way.
In the worst case, if treatment denied by insurance results in a death, the cost in a wrongful death situation is often thousands of times the cost of the treatment that was denied, or more. One time I served on a jury in such a case and the penalty went into millions because a test that would have cost perhaps $100 wasn't done.
Ultimately costs are a big part of determining how to treat people, but delay and denial of the treatment recommended by the Doctors often cost more in the long run. Worst case, Doctors won't even discuss the best form of treatment with the patient up front as they know the insurance won't allow it. If the patient gets worse, they know they can then use it, but not until they tried the cheaper approach.
Gary
