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longfellow, I am somewhat puzzled by alpha's video

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meirluc   Wednesday, 06/03/20 06:33:38 PM
Re: longfellow95 post# 287161
Post # of 299886 
longfellow, I am somewhat puzzled by alpha's video perhaps because it is hard to believe that in the DCVax-L trial, after a certain time (36 months?), the decline in the rate of progression was much greater than it was in other GBM trials. In fact, after a certain time on trial, the curve seemed to show hardly any additional progression events.

My eyesight is not the best and I was therefore not able to identify from the graph the time on trial when this sharp decrease in the rate of progression events was initiated.

From the November 2018 update of the JTM publication we know that there were about 93 post 36(+) months survivors and that update estimated that only 50 of them (54%) were going to live 58.4(+) month and 46% would unfortunately suffer the final event. While I am estimating that we may end up with perhaps a few more than 50 long term survivors (perhaps 55), that would still represent an attrition rate of 41%.

While an attrition rate of 46% or 41% in the numbers surviving between 36 months and 58.4 months is much lower than normally expected, it could not have happened without a modest rate of progression. That rate would most likely gradually decrease with time but that would still be visible on the graph. Also the attrition is not likely due to the death of placebo/control patients because I believe that few such patients survive 36 months.

alphapuppy's conclusion that there were hardly any progression events after let's say the 36 months timeline, leads one to believe that almost all OS events occurring after 36 months were due to pre 36 months progression events This is a revolutionary concept. Dr. Liau pointed out that most of the post 36 months survivors arrived at that timeline with their PFS intact. If alphapuppy is correct, then the overwhelming majority of the deaths occurring from 36 months through 4, 5, or 6 years or even beyond, are patients who progressed before their 36th month on trial. Patients who are PFS at 36 months hardly ever die thereafter from GBM.

If I am missing something I would appreciate if you or someone else can explain to me where I went astray.


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