I actually believe that DCVax-Direct, once approved, will be used in other ways as well. In the case of my wife's breast cancer a quarter century ago, it was a few months between diagnosis and surgery. From what I've observed, that hasn't changed much, it just doesn't happen that quickly.
I believe that on discovery of a tumor, operable or not, DCVax-Direct could be made and injected into the tumors. If the tumor is, or shrinks to the point it's operable, the advantage of injecting it would be that any mets that can't be detected and/or removed in the surgery would have the Direct working against them. The tumor may be used to create DCVax-L to reinforce the treatment, but hopefully the mets die off, rather than needing further treatment.
Sadly you really never know that all the cancers been removed and won't reoccur. My sister was about 10 years post treatment when a cancer reoccurred, her oncologist had told her no need to see him again, but it was caught in a physical by a new Dr. She's undergoing experimental treatment, I frankly wish they could try DCVax-Direct.
It will probably take several years after initial approval for other applications of these vaccines to evolve, and by themselves they'll probably be shown to be of benefit, but not curative in most cases. The thing is, if other protocols are working, they'll be shown to work better with the addition of DCVax L and/or Direct.
Gary
