NP - ONTY:
1) First, a bow of respect for a well researched response
2) Second - this thread was about comparing the worthiness of Shkrell article vs last week's Rah, Rah article. Shkrell's article had multiple cites, which may not be wart free (when are they ever?) but were are at least reasonable. Last week's SA article had no such cites - just blithely ingesting an assumption of 20 weeks for control arm of START trial.
3) Finally, on the topic of the individual cites. You got into more depth than I on the topic of the Shkrell cites (cool!), but let me build on that and/or generally respond:
3a) I'll let stand your comments on not-comparable-because-of-small-size-and-potentially-having-a-game-changing-new-protocol with only the response of 'yep, not a lot of comparable protocols of reasonable size- but how likely is it that these small trials stumbled onto the holy grail of nsclc treatment'?
3b) The Kelly trial - your response was However, the selection criteria for this study were rather stringent and only about half of the patients who were initially eligible underwent randomization as you can see in this chart. So essentially the trial weeded out patients who were likely to have a worse prognosis. My comment back is that START requires something similar "Documented stable disease or objective response, according to RECIST, after primary chemoradiotherapy (either sequential or concomitant) for unresectable stage III disease, within 4 weeks (28 days) prior to randomization.". The Kelly trial MIGHT be more stringent in this regard (successful induction therapy) or it might not. Hard to tell from the limited data from Clinical Trials exactly how the START requirement for successful induction therapy is being applied. But counterbalancing that would be multiple things - after START induction the patient still needs to be PS 0/1. (Kelly trial doesn't show that as a weeding out). And START excludes the sickest iiib patients (pleural infusion), whereas Kelly excludes N1 patients (the least sick patients). Net/net I'd say the Kelly trial is a very reasonable comparison and it had a much longer time to death than assumed by the ONTY bulls.
PS It is a pity that Shkrell focused on the science as the basis for his belief that Stimuvax is a worthless treatment (his science was shoddy). If you believe Shkrell's historical compares (see above) then this, by itself, provides powerful data that Stimuvax isn't worth much. In the post hoc subgroup picked out of the ph iib trial it was always known that the control group did much more poorly than they SHOULD have (in the ph iib the Stage iii Locoregional control group survival was the same as the remaining stage iii and stage iv control group at about 13 months - which is completely non-credible). In the ph iib post-hoc subgroup that formed the basis for the ph iii the control group did about 13 mo vs 30 months for the treated arm of that subgroup. But if that control group should have had a survival near 30 months then essentially all treatment effect goes away entirely. I.e. the post hoc from the ph iib stumbled on an anomalous subgroup of the control arm - not some group in which the treatment works.
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