NorthWest Biotherapeutics Inc (NWBO)

[biosectinvestor]

Surprisingly negative post Gary.

I do not generally put up numbers but I don’t intend to sell for $3 per share either.

So, I am breaking my general rules to put up some numbers that I do not think are unrealistic, to bat about. These are not trillions nor every cancer under the sun. In fact, I think they miss huge categories like recurrent patients and patients from markets beyond the big 4 we have already potentially just ahead.

Let’s consider first the UK.

Market size of the UK, of course I do not necessarily presume all patients could be operated on or be patients getting DCVax-L, though I do think there will be a lot of off-label patients with other cancers who may want to get DCVax-L, if they can, once it is approved.

However, here is what ChatGPT said about the size of the brain tumor market broadly defined as in the new application, in the UK, but it has a hard time coming up with a recurrent patient set of numbers, mainly newly diagnosed:

“Yes, that appears to be the correct interpretation. The figure of around 3,200 annual cases specifically pertains to newly diagnosed Glioblastoma (GBM) in the UK. In contrast, the larger number of around 12,300 includes a broader range of brain, CNS, and intracranial tumors, encompassing both malignant and non-malignant types, not just GBM. This broader category results in a higher total number of cases due to its inclusivity of various types of brain-related tumors.”

Then I asked how many get surgery, and it came up with a fairly conservative number and affirmed the 12,000 number again.

“The specific percentage of brain tumor patients in the UK who undergo surgery, including those for GBM, isn’t explicitly detailed in the sources I found. However, general statistics on cancer treatment in England from 2013 to 2016 indicate that 45% of cancer patients were treated with surgery. This figure includes various types of cancer, and the proportion specifically for brain tumor patients might differ.

Additionally, The Brain Tumour Charity notes that over 12,000 people are diagnosed annually with a primary brain tumor in the UK, including 500 children and young people. This figure aligns with the estimate of around 12,300 new cases of brain, other CNS, and intracranial tumors mentioned by Cancer Research UK.

It’s important to note that these statistics cover a broad category of brain tumors and might not provide a direct answer to your question about the specific surgical treatment percentage for GBM or other specific types of malignant gliomas. The treatment approach can vary based on several factors, including the type and stage of the tumor, patient’s overall health, and specific medical circumstances.

For more detailed information, consulting specialized medical databases or direct inquiries with health institutions or cancer registries in the UK might provide more specific insights into the surgical treatment percentages for GBM and other malignant gliomas….”

So let’s take the 45% number, x 12,300 = 5400 patients.

As I said, I think there will be patients with other tumor types, seeking this treatment. But, let’s presume we have these patients, and a $250,000 price tag for 2 years worth of vaccines.

That is revenue of 1.35 Billion.

I am not for the moment going to try to boil this down further, but let’s say the market cap is reasonably, 15 x that number because the market will know this is a treatment with broad potential, and typically 15 is not an unrealistic number, it could even be higher…

That is $20.25 B market cap. Now if you are a market speculator and you think, if this was approved in the UK, the EU, US, Canada, and various potential treaty countries are not far behind…

Well, you see what can happen.

We did not look at those other countries, but, just the EU, with a larger population and Canada. It did not have numbers so we took the average of the incidence rates for these tumors for the EU and Canada.

First the U.S.:

“The incidence of glioblastoma and other malignant gliomas varies across different regions. In the United States, the annual incidence of malignant gliomas is approximately 5 cases per 100,000 people, with over 14,000 new cases diagnosed each year. This includes glioblastomas, which are the most common primary malignant brain tumors, with an annual incidence of around 5.26 per 100,000 population or 17,000 new diagnoses per year.”

So we let’s take let’s say 45% of 17,000, and again these are very rough estimates and do not address the recurrent market at all.

So, 7,650 in the U.S.

“ 1. Corrected UK Incidence Rate: Approximately 4.71 cases per 100,000 population.
2. Corrected Average Incidence Rate: Approximately 4.98 cases per 100,000 population (average of the US and UK rates).
3. European Union (EU):
• With an estimated population of 447 million, the EU would have approximately 22,274 new cases of glioblastoma and other malignant gliomas annually.
4. Canada:
• With an estimated population of 38 million, Canada would have approximately 1,894 new cases annually.

These corrected calculations provide a more realistic estimate of the number of cases in the EU and Canada, considering the average incidence rates from the US and UK.”

45% of the EU cases is, 22,274 x .45 =

10,023.3

For Canada: 1,894 x .45 = 852.3

An additional 18,525 patients, beyond the UK in likely immediately addressable markets.

18,525 x 250,000 = $4.631 B

Additional potential market cap:
4.631 B x 15 = $69.5 B

Let’s add the UK from earlier above:

$20.25B + 69.5 B = $89.75B

Potential addressable market, not market cap.

Let’s say, though I think it is short a bit, but let’s say this is the addressable potential market for newly diagnosed brain tumors, excluding recurrent tumors, in the 4 markets where NWBO will initially apply, not including broader global markets, not including off-label or extended label either, though the market might consider those possibilities if it were well informed.

Generally I do not do this and generally speaking, that is a way larger number than I usually come up with when I think about this in the next few years.

Granted not all patients will be reached. Not all patients will have the care that would make this treatment possible. Not all patients will live to get their second year’s dosage or have enough tumor to get more than 3 doses perhaps. We also do know that brain tumor cases are growing.

This number does not include recurrent patients, which is a large number. Nor does it include off-label or extension of label patients that seem likely to me, even if just a small percentage of other tumor types, it could be a substantial number in total.

I agree with people who suggest NWBO seems to be making very little effort to be around for a long time to address or grow even to reach just this market. But I also think you don’t need thousands of people in executive suites to get this market either. The limitations will be growing production and operational personnel fast enough.

I provide these back of the envelope, very crude numbers not to encourage the people saying 1 trillion, nor to address those saying 5 billion. I definitely think the broader market may think it can only address a smaller sized market or the team is not going to be around.

However, on its worst days, with multiple competitors and a limited blood cancer market, with dead patients, no less, my Car-T investments pre-approval were at 4 to 6 billion market caps with 10 billion or so at buyout.

And we know one thing for certain, if approved, NWBO is grossly undervalued.

Nor you can discount those numbers above. Let’s say you want to say, assume true revenue after costs will be 50% of those numbers.

OK, that gets you to $44.87 B.

Then let’s say we want to say even if approved in those markets, they might only reach 50% of those patients.

OK, down to $22.437B

OK, but the market knows there are still very large markets to address, including recurrent cancers, off-label and extended label patients, and other markets beyond the U.S., UK, Canada and the EU.

Reasonable markets do speculate.

With the right partnerships, there is no reason they can’t reach 22B and beyond fairly quickly, if they have the backing and team in place. I think that is a conservative view and of course assumes a broad brain cancer approval. But even then, 22B is very discounted from what the potential could be.

We’re of course not looking ahead to other versions of DCVax either. Not to other “trials”, though I believe they have many patients already from compassionate use and other cases and real world data that could be assembled subsequently, that could more quickly extend the label. To large and small additional oncology indications.

No need to consider other things like viral applications at this time. They’d have way too much on their hands.

I do think the management team would likely step aside, LP would likely stay on as Chairperson of the Board, CEO Emeritus. But I also think they need a large pharma to help fund expansion and validate to markets that do not as of yet understand this opportunity. I could be wrong.

This is not something I typically do, just a crude and rough, back of the envelope discussion to keep things from collapsing into the “I will sell for $1 category of conversation”.

People may challenge the ChatGPT market size estimates. Completely reasonable to do. But I do not think they are hugely off, I discounted them by 50%, and further presumed only 50% of those would be addressable again. So really took 25%. We reduced the revenue by 50%. We still got quite a reasonable number but also recognizing that there are many more addressable patients in the recurrent market, off label and extension of label as well as additional global markets for the baseline patients.

$22B

I think a fair buyout number might be something north of $30B on approval in 4 jurisdictions, which seems highly likely to me, if early, but obviously, some shine would need to be put on here, in terms of the market understanding of this opportunity.

Shorts look to be fading a bit, but can make a comeback. So the reality is, deals and validation tend to work like “protection money”. Despite our beliefs that we are an advanced society, the reality is bandits have found ways to adapt. They don’t so much steal your money on the roadside, they steal in the marketplace, in broad daylight, in everyone’s view, and with the police looking on, but unable to do anything because it looks legit.

We can’t address that manipulative thievery absolutely, and we can’t necessarily claim the full potential of the market immediately, and maybe never. But there will likely be a lot of demand and a strong effort to meet as much of it as possible. And this all speaks to just the potential for brain tumors.

Have fun batting about those hypothetical and very loose, back of the envelope and crude numbers.