I have a theory for Small's silence. I think it may have to do with his trials on GM-CSF and MDX-010 (ipilimumab) for HRPC. See 2007 ASCO abstracts 49 and 4609. It being a holiday, I am feeling too lazy to go back through DNDN's results to see how Provenge compares with his observations of 3/24 patients showing 50% reductions in PSA (fairly consistent across three protocols using ipilimumab alone, or in combination with GM-CSF, or in combination with Taxotere).
Clearly this is a future competitive threat to DNDN, IF it turns out that general immune stimulation is sufficient to give a similar long-term clinical response. It's a big if, but it would be another way to explain why there is no immune response against native PAP, as you point out. That is, the explanation is that no such response is necessary; the infusion of GM-CSF-stimulated DCs is enough to stimulate the appropriate T cells. And if that were the case, injections of ipilimumab with or without GM-CSF would be an easier way to achieve that.
So Small's silence might reflect some distance growing between him and DNDN. He clearly has his hands full with various trials, and he now needs to maintain relationships with other companies such as MEDX, so he may be unable or unwilling to spend extra time or go out on a limb for Provenge.
Anyway, a happy July 4th to you, too, rancherho.
AI
