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flipper44

07/19/19 1:35 AM

#236897 RE: hyperopia #236891

It's sort of opposite to the Olympics in the manufacturing world. We went over and over this many years ago. If a biologic manufacturing process improvement (typically to prepare for commercial scale production) does something like get a higher purity of cells, you worry if the modification causes safety problems or adversely impacts efficacy. On the other hand if the impact is not adverse in either case, then one must look at these changes with a pragmatic eye toward the better outcome. If we do not handle these (potential) manufacturing preparations with common sense, then we continue to die. The trial has gone on long enough, that if there were manufacturing changes back in the mid-10's, preclinical bridge studies, plus the restraint on unblinding the trial (again to a clinical bridge study), has allowed the trial to provide ample evidence of similarity over the course of another four years -- even if the final result is somewhat superior.

Biology is so much more complex than anyone understands, and it throws curveballs and an occasional fat pitch. This time the pitch was straight over the plate. IMO. The Royal Society wrote a paper suggesting biological manufacturing enhancements for such qualities as higher purity should be simply treated as a higher dose.

The other fact is the use of 5-ala in guided surgical GBM resections may allow removal of more tumor tissue. Thus enabling DCVax-L to get the upper hand early.

Again, if regulators are rigid and inept, they'd simply reject any obvious improvements in outcome based upon otherwise obvious causation. Again, this trial has run on long enough, since any of those changes might have been implemented in the trial, that blinded followup is akin to a clinical bridge study in and of itself.

As a species, we must be smarter and think on our feet instead of continually throwing out the baby with the bathwater. New potentially life saving paradigms and the patients they might save demand better from us.
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Doc logic

07/19/19 10:46 AM

#236927 RE: hyperopia #236891

hyperopia,

I can't "know" as that has not been publicly disclosed. What I can do is reasonably ascertain that this is the case just as flipper44 has laid out the case. I also know what Fraunhofer's strengths are and they fall right in line with what regulators want with regard to equal aliquots of cellular based vaccines and safe manufacture of same. NWBO will not say anything to even hint that any potential changes could have led to improved results. They don't even want to talk about equivalency because the bears would start a firestorm challenge seeking discovery. Thinking like a lawyer can save lots of headaches sometimes even if the result is painful silence for investors. By the way, the bears have NO answer for improving 3 year outcomes as that does not fit a futility thesis. Best wishes.