Hi, Gary. The SOC ("Standard of Care") is essentially a guide as to the best way to treat a medical condition. It is not a legal document but in the UK (I cannot speak for the US) it is expected that doctors will follow the guidelines as this will give them a degree of protection if all does not go well for the patient. In those instances if doctors do not follow the guidelines competently they could be exposed to the criticism of not having treated patients correctly. In essence, doctors then have to prove their innocence rather than innocence being assumed. In the UK the guidelines are essentially set by the various professional bodies (such as the Royal College of Physicians, Surgeons, Obstetricians et al ) and are recognised as such by the General Medical Council (the regulatory body which licences medical practitioners to work in the UK), the legal profession and medical insurers.
The SOCs are not set in stone so the answer to your question is a simple, "Yes, DCVax-L could be added to the SOC without further ado, with (if the clinical evidence is already sufficiently strong) pre-treatment with poly-ICLC followed by pembrolizumab also being added". For a more radical changes such as the removal of temozolomide, a controlled trial would almost certainly be needed to ascertain whether removal resulted in increased or decreased survival.
Best wishes.
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