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Hopeforthefuture3

12/08/22 4:41 PM

#546019 RE: biosectinvestor #546012

Would like to think professionals in this field would recognize a treatment that shows a solid improvement. I chalk it up to ego - wasn't his research so can't be that good.
Imo I doubt it was due to nvcr there is more than adequate need in this disease for multiple approaches.
The combination data shared by Dr Liau though early and on a small group is certainly impressive
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OncoJock

12/08/22 5:22 PM

#546045 RE: biosectinvestor #546012

So, I'm a professional medical writer/editor and the first thing that strikes me is how poorly written and edited is this commentary by the famous Roger Stupp. Admittedly the headline is strong: "2022 Top Story in Oncology," but he likely didn't write the headline. Moreover, that headline makes a promise to the reader that the story itself comes nowhere near to delivering.

What, exactly, makes this the top story in oncology for 2022?

I can think of several things, but very few are even mentioned in this commentary.

1) Extraordinary mechanism of action of murcidencel
2) Extraordinary progress against a famously recalcitrant (and horrible) tumor type after hundreds of prior failures
3) Extraordinarily benign safety profile (totally ignored in this commentary)
4) Extraordinary promise (admittedly in the early stages) of this treatment when combined with other modalities especially PD-1 checkpoint inhibitors

You (my fellow iHub readers) can probably think of other extraordinary story angles that I'm missing.

To be fair, there is one extraordinary aspect of this story that he did properly focus on: the use of an external control arm to demonstrate efficacy in a phase 3 trial in glioblastoma. But even then, the position he takes is so wishy-washy. He ends up in the final paragraph saying that there are both pros and cons to using external control arms, which I'm sure is true, but is that really what makes this the top oncology story for 2022? He missed so much else.

He gets bogged down in details right from the beginning. For example, in the lead paragraph he gives detailed progression-free survival (PFS) data, but we know that PFS is notoriously unreliable in this context (using intracranial imaging to gauge response to an immunotherapeutic agent). To his credit he does mention this difficulty in the next paragraph, but then why did he give it so much emphasis in the previous paragraph?

This commentary reads to me like a first draft he dashed off in a rush without taking the time to revise it, and without the benefit of an editor. Yet the story is labeled under "Editor's Picks" on the Practice Update website.

Sigh. This is why they pay medical editors the big bucks -- to prevent embarrassing disasters like this. Maybe the people who run the Practice Update website are having trouble hiring professional, skilled editors who are up to the task of working with an eminent authority like Professor Stupp on a story like this. Or perhaps they were in a rush to publish first. Or perhaps the good professor refused to let anyone else touch his precious prose. Whatever the answer, he did himself no favors by allowing this not-ready-for-prime time article to reach the eyes of the reading public. (IMHO)

-- OJ
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meirluc

12/08/22 5:47 PM

#546058 RE: biosectinvestor #546012

Bio, I believe that Dr. Stupp's failure to mention the beneficial effect of DCVax-L for rGBM patients was no accident because that would have been the weakest point in his argument.

Deducting the 81 treatment patients alive at 24 months from randomization (NYAS presentation) from about 129-132 patients alive in the entire trial at 27 months from surgery (24 months from randomization, 2018 JTM article, fig. 1), we have about 48-51 living patients at 24 months who were in the combined group of 99 patients (65 crossovers and initially 35 non-DCVax-L treated patients.) Since Dr. Liau in her recent webinar stated that 7 of the 35 never treated patients dropped out, we are left with 64 crossovers and 29 never L treated patients. Since Dr. Liau also stated in the webinar that most of the 29 who were never treated with DCVax-L did rather poorly, it is a no brainer to conclude that at 24 months, of the 92 remaining patients in that last group, about 48-51 were alive and about 41-44 were deceased and that very few of the 48-51 survivors were never L treated patients and therefore the overwhelming majority of those 48-51 were crossovers.

This suggests that the mOS of the crossovers is well in excess of 24 months from randomization and that can only be attributed to DCVax-L treatment at progression and cannot be due to cherry picking or any other trial manipulation. It therefore makes sense for Dr. Stupp not to mention the rGBM results.
Bullish
Bullish