NorthWest Biotherapeutics Inc (NWBO)

[longfellow95]

We know that even with proneural GBM, (which may be primary or secondary), there is frequently a subsequent shift to mesenchymal!
And that shift may have already started by the time of diagnosis of a high grade glioma (whether you call it a GBM or not).
And because of intra-tumoral heterogeneity, there will be elements of both in the same tumor at the same time, because the shift doesn't happen overnight!
For these reasons, and because of the paucity of any available large data on the issue, I would not adopt a dogmatic opinion that L does not 'work' with secondary GBM's.
In the absence of anything proven to be better, if I was an NO or a neuro-surgeon or a regulator, I would not deny DCVax-L to a patient diagnosed with a secondary high grade glioma. Nor would I want to be so denied if I was such a patient!
The alternative would be to wait until a recurrence, when the tumor has likely shifted to mes. And by which time the patient is likely to have experienced significant functional deficit. Basically a lot iller.
And that doesn't make sense to me, given the benign safety profile of L.

I suppose you could hypothesise the idea that you should wait a while with such a patient, because it appears to be the chemorad treatment itself that induces or accelerates the shift to mes.


"Proneural-Mesenchymal Transition: Phenotypic Plasticity to Acquire Multitherapy Resistance in Glioblastoma"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600373/