NorthWest Biotherapeutics Inc (NWBO)

[DocLee]

I started my discussion with an essentially semantic argument - a discussion about what constitutes "vaccination" as distinct from other forms of medical treatment. I thought this might be of passing interest to others as "Vaccination" is historically a specific form of immunisation; the giving of cowpox virus (variola vaccinae) to an individual to prevent the later development of the infinitely more dangerous human smallpox (variola). This distinction is now irrelevant (but still interesting, I believe) because the term "Vaccination" has now become so hackneyed as to encompass all forms of immunisation as demonstrated by the opening sentence of the article whose web address you provided; viz.

Traditionally, vaccines are designed to stimulate the immune system so that it can prevent disease-causing organisms (pathogens) from establishing an infection.

My first paragraph ended with the statement

With the DCVax family we now have the first examples of established disease being treated by vaccination (incorrectly named from my point of view).

"Therapeutic vaccination" has entered the medical lexicon to encompass the means of using immune system activation (correctly called "immunisation") for therapeutic purposes to treat established disease. It really should not be called a form of immunisation, let alone vaccination, but again, this is a matter of semantics. It is irrelevant to what I postulated as a possible future use of the DCVax methodology and which was the aim of what I wrote.
As to the 3 examples of "therapeutic immunisation/vaccination" which you provide:
1] I do not think the the use of BCG in the treatment in non-disseminated bladder cancer really fits the description of a specific immune system activation. Its mode of action has not (as far as I am aware) been elucidated - it has certainly not been found to stimulate the immune system to specifically attack the cancerous cells - and appears to be the result of a generalised inflammatory response of the superficial bladder which as a side effect destroys some of the cancerous cells. It is ineffective if the tumour has extended into the muscle layer of the bladder indicating the lack of any systemic effect. It is not much different than the pre-antibiotic era treatment of syphilis by infecting the patient with malaria. This killed many of the spirochaetes (which are heat sensitive) during the recurrent bouts of very high temperatures that malaria causes.
2] Provenge - my mistake; the DCVax family is not the first "therapeutic vaccination" but is the second.
3] Imlygic: As far as I'm aware, the modified oncolytic herpes virus that is used attacks only the melanoma cells in the immediate vicinity of the injection and any immune response is localised, not having any effect on distant metastases. This is possibly because the oncolytic virus does not spread far from the site of injection due to the response by the host's immunological system. I would hesitate to call this any form of immunisation as the damage to the melanoma cells appears not to be due to immune system activation as distant sites of malignant melanoma cells are not attacked.