The other reason it is important to have surgery near the time of DCVax-L treatment is because once recurrence occurs, the organized tumor is once again able to send immune suppressing signals near and far, and because the tumor starts to double so fast, DCVax-L should be accompanied with another tumor resection. Only three such cases of recurrence with second surgery + DCVax-L were reported in March 2017.
If that were the case the IDMC would have stopped the possibility of crossover during the trial because of lack of efficacy. But the oppositie happened: more patients than expected chose to crossover probably encouraged by their doctors who saw great crossover results.
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