Replies to post #474458 on NorthWest Biotherapeutics Inc (NWBO)

[sukus]

Thanks for the analysis Meirluc. Thanks for sharing.

[ATLnsider]

meirluc, are you saying that all or most recurrent GBM tumors are mesenchymal?

[skitahoe]

The reason progression occurred faster in the trial group is simple, the vaccine was working and it was viewed as progression, but it was actually pseudoprogression. We all need to realize that pseudoprogression is the vaccine doing it's job killing the cancer. The fact that progression was called faster in treatment patients should clearly be viewed that for those patients who's tumor swelled in size, but was actually mostly dead matter, the vaccine was working.

We really don't know if in some patients where it's working the tumor doesn't swell, but rather shrinks and perhaps disappears completely, the point is, we really don't know. We don't know how many of those patients that lived for 5 years or longer were actually determined to progress at some point, or did their cancers just disappear, or become dead matter. I believe the other case is if the cancer can be completely removed in the surgery, if so, it might never come back, or if it does if successful the vaccine may eliminate it.

Of course we still know that nearly 90% are still dying, less than half of who would die without the vaccine, but clearly more is needed and UCLA has clearly found that Keytruda is something that does when added to treatment with the vaccine.

I believe that much more will be revealed in the Journal, but much still remains to be learned once the vaccine is approved and Oncologists like Dr. Liau can try other off label treatments to try to extend or save the lives of their patients.

At City of Hope I've met many people who were given up for dead elsewhere who're doing great decades later. I'm sure that Dr. Liau and others working with her, and elsewhere have similar stories where when all the approved therapeutics have failed they've experimented till they found something that worked. The key is getting the vaccine approved, then it becomes a tool which Doctors can experiment with. Perhaps something as simple as a different dosing protocol will yield dramatically improved results, but it's not something that can be done in the middle of a trial.

Gary

[Dan88]

I have explained this in one of my previous post: https://investorshub.advfn.com/boards/read_msg.aspx?message_id=168865226.

Background: the control [edit: treatment] consists of 232 nGBM patients; the control consists of 99 nGBM patients initially, and then 64 patients of the 99 patients who crossed over to receive DCVax-L treatment plus 35 patients who have never been treated with DCVax-L.

It's known that about 30–49% of GBM tissues have been classified as the mesenchymal subtype. Patients with this subtype, both with primary and recurrent tumours, tend to have the worst survival rates compared to other subtypes (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6485274/). [Before DCVax-L emerges as the most effective treatment for this group, see below]

The beauty with DCVax-L in treating this subtype of patients is that as Dr. Liau has persistently pointed out over the years, despite the worst prognostication of this type treated with any other treatments available before DCVax-L, it has shown stellar efficacy when treated with DCVax-L [this conclusion can trace back to when Dr. Liau conducted Phase1/2 DCVax-L trial for nGBM more than a decade ago].

Patients from the control (n 64+35) at/after the recurrence those 64 patients have significant higher percentage of the mesenchymal subtype than that of the treatment arm (n 232).