Submitted by Sorin61 t3_z563cl in technology
Comments
The-Fox-Says t1_ixuydyk wrote
I work in the clinical trial space and this is exactly why we developed synthetic control arms. Patients can get the drugs/care they need and we can still get FDA approved trials that are double blind to have a similar outcome from a placebo arm trial.
It also really helps with rare forms of cancer where the cohorts are tiny.
itwasquiteawhileago t1_ixvdc9l wrote
Some of the oncology trials I've been on compare IP to SOC. In many cases SOC is what they call "watchful waiting" (i.e., doing nothing). I'm no oncology expert, but I do work in the clinical trial space and have worked on dozens of various oncology studies over the years and see this regularly. Often times they can cross over from SOC to study drug if their condition worsens within a certain timeframe, but how they make those decisions when developing the protocol is not something to which I am involved.
I know sometimes the best results only really mean maybe a few more months before the inevitable. Those trials are rough because people just want to live the rest of their lives as comfortable as possible, so being in a clinical trial that, best case, may extend their life a few months, is not always appealing. But without these trials, we'll never get anywhere in the long run.
H2AK119ub t1_ixvvblk wrote
Your latter point is probably why this trial took such a long time to accrue patients. Also, the difference between the treatment and external control in primary disease is 3 months for OS. IME - watch and wait is used for low grade disease.
impy695 t1_ixw797b wrote
Would you be willing to explain what a synthetic control arm is and why are they better? I've never heard the term before.
Dzugavili t1_ixwakfp wrote
Basically, you make a fake control group using data from previous patients: eg. 90 days into a clinical trial, you'd expect X% of patients in the control group to have died, and if you know that for certain, you don't need to have a control group actually sit there and die for you to confirm it.
impy695 t1_ixwbat1 wrote
Interesting, how would it work with thr placebo effect? Or is it something you use in separate trials for the same drug that way only some trials have a placebo group?
Dzugavili t1_ixwby4y wrote
I suspect in most cases, you'd be able to recycle control data from a previous study, and hope their placebo effect should be similar enough; or that your treatment effect is substantially stronger than optimism.
But given the kind of conditions we'd be likely to use this methodology for, I don't know if the placebo effect has a strong effect on outcomes.
puffferfish t1_ixy59sb wrote
A “placebo effect” isn’t really applicable in this case. It would be optimal to have a control for patients, something like giving them a pill with every ingredient aside from the drug, but this is likely not going to influence something like brain cancer. Brain cancer will not be influenced psychologically, and there is enough data to know on average how long patients with this cancer will survive. In a phase 3 trial it is important to get enough patients to participate for good statistics, and to do it as ethically as possible. To do this, you can just leave out an active “placebo” arm of the trial.
beesgrilledchz t1_ixwxhx9 wrote
Thank you. Thank you for your work. I hope we can one day help everyone with these tumors.
PNET gives me nightmares.
I have had far too many conversations with families saying “we possibly can’t save your child but if you are willing to try, we might save another child in the future. Leukemia was once a death sentence. It’s treatable now, because there were families like you, willing to try”
I’m going to go cry for every one of those kids and their brave families, who were willing to try.
I see their faces in my dreams.
Edit: that was too nihilistic. I have seen kids signed up for highly experimental trials who were doing really well
DubC_Bassist t1_iy060bk wrote
“Synthetic Control Arms”?!! I’m not negotiating with a Cyborg.
ForProfitSurgeon t1_ixvdoeg wrote
We need to make sure we do enough human testing before it is ready for the rich.
greatnessmeetsclass t1_ixuvzez wrote
In any study for any condition severe/life-impacting enough to require medical intervention, pure sham-arm with no crossover is unethical, cmv. With GBM that's even more true of course.
Whites11783 t1_ixuw07s wrote
Yeah, I was going to say, tough to not offer crossover to that patient population
klipseracer t1_ixuy7av wrote
I presume that means to offer them the medication at some point instead of a placebo?
H2AK119ub t1_ixv0sac wrote
It's effectively a single arm, uncontrolled trial; all patients involved in the "placebo" eventually cross over to the treatment arm. The investigators of the trial state that extracting DC's from GBM patients with poor prognosis is unethical without providing treatment.
Z-Chomosome t1_ixvmzpz wrote
Can’t you just look at historical data? The way statistics are used in medicine seems deeply Byzantine.
H2AK119ub t1_ixvn8f6 wrote
You need exquisite controls when looking at historical data. Modern medicine has advanced incredibly in the past 20 years with technology and that can significantly blur the data.
Kraz_I t1_ixwj8i4 wrote
Can useful statistical data be gleaned from many hundreds or thousands of case studies, considering how common case studies are recorded for cancer patients?
Rodot t1_ixx2lzk wrote
Yes, to highest order the fractional error (percentage of the outcomes the error represents) goes as the inverse square root of the number of samples. Barring other factors such as experimental design and representation of the samples, you're usually hitting around 1% error at 100 samples.
One doesn't actually need a ton of samples to get good statistical significance depending on the design and results of the study. Of course, there are factors that can increase or decrease these rates depending on if you are getting a little Bayesian or not
BaLahKie t1_ixwrbry wrote
Maybe this is a dumb question but why would you need a placebo for something like this? A person can’t really have a placebo effect where they think they’re getting better here right? It’s either improving or it’s not, like it’s tangible evidence you can track.
Or am I misunderstanding the point of placebos?
H2AK119ub t1_ixwrw26 wrote
Your control arm in a clinical trial can be placebo, standard of care (SOC), watch and wait, or a combination. The FDA has approved first in class medicines in high unmet need populations using ph1, single arm, non-randomized/blinded trials; they have stated recently they will probably do this no longer which is causing a big stir in pharma/biotech space. The DCVAX trial was plagued by many issues. Pseudo-progression of patients being a major one. They had to change the efficacy readout from PFS (time to disease progression) to OS (death) because they could not accurately readout from MRI's if people were getting better due to pseudo-progression. This is probably why the trial was so long.
BaLahKie t1_ixwsfxe wrote
As someone who came here from the Reddit news section, I appreciate your reply and you used a lot of complex jargon so I assume you are correct
H2AK119ub t1_ixwsmu6 wrote
LOL. The FDA will approve the drug if they believe it provides a meaningful clinical benefit to patients. That's all that matters.
twnbay76 t1_ixx14c5 wrote
Your link is broken
d0ctorzaius t1_ixxu25k wrote
Just as an aside, I work on H2BK120Ub so I appreciate your username.
bilyl t1_ixvskew wrote
This will for sure be approved shortly.
H2AK119ub t1_ixvuxi7 wrote
The effect on OS for primary disease from point of randomization is 3 months (compared to the external controls). The FDA will need to decide if that is clinically meaningful.
bilyl t1_ixw1apo wrote
Considering that there are plenty of oncology drugs that give one month of OS because of the dismal outcomes of specific cancers, this is a sure thing. Getting this data in a phase III trial just seals it.
H2AK119ub t1_ixw1tnd wrote
Can you name an example of this "one month life extension" drug in oncology?
bilyl t1_ixwgjia wrote
I’ll have to do a bit of research, but off the top of my head there are a couple of drugs that are in that range: Vemurafenib (metastatic lung cancer, ~3-4 months OS improvement), Crizotinib (~4 months), trodelvy (3.2 months for metastatic triple negative BC), trastuzumab (gastric cancer, <3 months), cetixumab (CRC, 1.5 months).
H2AK119ub t1_ixwrb6q wrote
Not sure why you've focused on (mostly) old drugs and kinase inhibitors (known to be very dirty). Vemurafenib (BRAFi) is indicated and used in melanoma not NSCLC (another first for FBDD), Crizotinib (ALKi) is focused on ALK fusions, Trodelvy is a first in class ADC, Trastuzumab makes billions annually and is SOC in HER2+ breast cancer, and cetuximab is an old EGFR mAb that has been mostly supplanted by anti-VEGF mAb's in CRC (with FOLFOX chemo).
bilyl t1_ixxoyi6 wrote
I didn’t specify anything about whether newer drugs fall into this category, but it was very routine that older targeted inhibitors (especially kinase inhibitors like you said) were approved in the past 15 years (not that long ago!! I was in graduate school at that time) for very marginal benefits. So yeah, there are way better drugs now but drugs with marginal benefit were being approved “back then” because there was nothing better and because survival was really dismal.
[deleted] t1_ixwjh5s wrote
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H2AK119ub t1_ixwptan wrote
This is not how a clinical trial works at all. Nor is it how SOC treatment works for primary disease. Doctors (ie, oncologists) don't just try "random" treatment options.
twnbay76 t1_ixx29ez wrote
The question was about how the average was calculated, i.e. simple mean, weighted average, etc...
And they are correct in the sense that patients that are unresponsive to medications are placed on other medications and modes of care. But yeah, certainly not randomly!
ThePlottingPanda t1_ixvfdko wrote
The current standard of care has only 5% of patients surviving past five years, and this vaccine allows 13%. That nearly triples the rate of survival, however small.
Definitely hopeful stuff!
DigitalParacosm t1_ixw0k01 wrote
And importantly: it’s giving patients who will die soon more time with their families. Often times they’re living for their families in these final months.
RaceHard t1_ixwt942 wrote
For those that can afford it.
DigitalParacosm t1_ixwtrk3 wrote
An excellent observation into how our privatized healthcare system robs people of the choice to live.
RaceHard t1_ixwuamw wrote
One day that will no longer be the case, once 3d printing technology reaches into bioprinting we may yet see true freedom in medical synthesis. Sure it will likely be outlawed but it will also be impossible to regulate much how it is now possible to fully 3d print guns at home. 10 years ago they looked like a joke, nowadays you can barely tell them apart at a glance. In another decade even an expert will have a hard time to know without handling them. Who knows how far the technology will take us.
DigitalParacosm t1_ixx2thv wrote
And for diseases that won’t be cured by 3D printing: there is gene therapy (like this drug we’re speaking of) and CRISPR.
7 years ago I mentioned medical 3D printing to a general surgeon and he humored me by saying the scaffolding isn’t there yet. It’s more than that though, one key challenge to any implant is your body rejecting and attacking it. Hell, just putting a random person’s actual kidney in your body requires you to be on tacrolimus (oral anti rejection medication) the rest of your life, and if you miss a single day your kidney may fail. We are a long way from dragging and dropping organs, we’re even farther from 3D printing them.
Either way, its entirely irrelevant to this discussion.
RaceHard t1_ixx7ol9 wrote
A few years ago my computer science professor went on a tangent about a colleague of his working on scaffolding apparently they were working on trying to create an agnostic cartilage material that would be in theory treated with indifference by the immune system. And that onto that material the cells of an organ could be sprayed on. The idea, (and I admit that it was explained in a high concept without details.) was that you would use the healthy liver cells of the subject to in practice grow a new liver. Thereby bypassing Immuno suppressors
That was back in 2016, I am not sure how far along that research currently is. But when we were told about it the outcome was not optimistic until 2030's.
PT10 t1_ixx0pbj wrote
Know a woman whose husband just died of this. After being diagnosed 4 months prior. Fuck cancer
WhatsIsMyName t1_ixx8ud2 wrote
I lost my brother to glioblastoma. From diagnosed to passing in 11 months with 4 grueling brain surgeries and continuously diminishing faculties. The only upside is that the actual process of passing is, in the end, mostly something that happens while they are asleep.
Wouldn’t wish it on anyone and hope beyond hope we can find a cure someday. L
blackweebow t1_ixwqu9a wrote
I wonder if we'll be able to afford it
EmiliusReturns t1_ixvdzv5 wrote
It’s good to see progress. Even without a cure for cancer, something that can give the person more time is great. Especially if it’s decent quality of life time.
That last sentence is key: trial participants reported no major side effects like those experienced with chemo and radiation (I’m paraphrasing the article.) That is huge. I’ve seen what chemo does to a person and I’d literally rather die. Hopefully one day we can use injections like this as an alternative treatment to chemo. I’m cautiously hopeful.
InternationalHatDay t1_ixvjxr3 wrote
everyone is different though, Im on chemo and its mostly Im more tired than usual.
virtuesdeparture t1_ixvz24o wrote
Chemo for different cancers is going to be different too. My dad died of GBM 2.5 years ago, just a year after diagnosis. He was a personal trainer, in better shape than anyone I know, when he was diagnosed at 58 years old. 6 months later, he was a shell of himself and barely tolerating chemo. I’ve been watching dcvax since he was diagnosed, hoping they’d fast track fda approval and he could get it.
This is bittersweet.
mmmegan6 t1_ixw762w wrote
I’m so deeply sorry for your loss. How are you doing these days?
MazakeenSmith t1_ixx7net wrote
My sister died of GMB 4 months ago. She took part in a trial, not sure if it was this drug. She lived almost 3 years after diagnosis, and she never complained once. Happy to think that other families will get longer, but sad that it’s not our family.
H2AK119ub t1_ixwt3px wrote
> Chemo for different cancers is going to be different too. My dad died of GBM 2.5 years ago, just a year after diagnosis. He was a personal trainer, in better shape than anyone I know, when he was diagnosed at 58 years old. 6 months later, he was a shell of himself and barely tolerating chemo. I’ve been watching dcvax since he was diagnosed, hoping they’d fast track fda approval and he could get it. > >
Big hugs. Sorry for your loss.
InternationalHatDay t1_ixwq3wp wrote
Im so sorry
CapnGnarly t1_ixw67ac wrote
Going through chemo was worse than living with brain cancer for me.
Newguyiswinning_ t1_ixx69xm wrote
There will never be a cure for cancer, only treatment. The fact people like you still dont understand this is why it is hard to get good treatments
EmiliusReturns t1_ixx6h7c wrote
Ah yes. It’s totally my fault chemo sucks, apparently. Silly me.
Seriously, why the hostile attitude? I never even said I thought there would be a cure but here you are with the guilt-trippy attitude for no good reason.
Common_Screen9450 t1_ixva78i wrote
Isn’t vaccine the wrong word? I thought vaccines prevented illness that you don’t yet have. Seems like everyone getting this treatment already has GBM.
ghkbrew t1_ixvbz4s wrote
A vaccine is a substance you give to stimulate an immune response against something else. Even traditional anti-virus vaccines aren't always given before disease exposure. E.g. rabies vaccines are almost always given after exposure. Typically after the 10 days of watching the possibly rabid animal that just bit you to see if it really had rabies.
unripenedboyparts t1_ixvf6aj wrote
Rabies given after exposure, but before disease. So that is still prophylaxis.
Edit: This is a small point and I'm not disagreeing with you overall.
Edit 2: Geez, I cannot type today. "Rabies after exposure, but before disease. Me Tarzan."
PM_ME_YIFF_PICS t1_ixvnjk9 wrote
You can always get it before, but getting it after a possible infecting event is definitely a good idea too
Cold_Turkey_Cutlet t1_ixx632a wrote
>Typically after the 10 days of watching the possibly rabid animal that just bit you to see if it really had rabies.
Wait wut? I don't think this is typical. That would require a captive animal... I suspect most people who got bit by a wild animal or stray dog or something don't end up with the animal in their possession or any opportunity to watch it for 10 days.
But it is an interesting idea if possible. Because apparently the rabies vaccine is horrible and not something you want to go through if you don't need to. Then again, I'm not sure I would want to sit there for 10 days taking my chances with actual rabies either, because if you don't take the vaccine by the time symptoms set in, you're gonna die a horrible painful death.
ghkbrew t1_iy0ivn0 wrote
You should go with what your local health department says, but yes a 10 day quarantine of the offending animal before starting prophylaxis is standard practice. At least for domestic animals. Wild animals are usually put down for testing if they're available I believe.
Aeonoris t1_ixvchjl wrote
> I thought vaccines prevented illness that you don’t yet have.
That's a "prophylactic" vaccine. There are also "therapeutic" vaccines, which train your body to fight a disease you already have.
Cold_Turkey_Cutlet t1_ixx5ixp wrote
First mRNA and now this?? I ain't taken none of them new fangled therapeutic vaccines! I want a traditional, Christian vaccine only!
Pinky-and-da-Brain t1_ixvke8w wrote
There is a newish thought in the cancer space that cancers like glioblastoma trigger your immune system in a very similar way to an infection so we should fight cancer like an infection. Also, this therapy trains dendritic cells (an immune cell type) to fight cancer which is what vaccines for viruses do (vaccines train immune cells). This “vaccine” is more of a personalized cell therapy than a traditional vaccine that you are thinking about but the name isn’t inaccurate.
H2AK119ub t1_ixvvqe3 wrote
This is not a new thought...the field of Immuno-Oncology has been around for decades.
Pinky-and-da-Brain t1_ixvxuvt wrote
I didn’t say immuno oncology is a new thought, I said treating cancer like an infection and creating therapies that target specific cancer is a newish thought. Your immune system remembers and targets infection with very high specificity, that is not true for cancer. Most cancer therapies over the decades have been either broad acting chemotherapies or drugs to increase tumor penetrating T cells (think pd-1 and the like). Training the immune system on specific cancers (personalized cancer therapy) like described in the article is new. These therapies are known as Car-T, dendritic cell therapies (what this article is about), as well as newer NK cell therapies. Dendritic cel therapy(cancer vaccines) require you to take a tumor biopsy, sequence the antigen, train the dendritic cell taken from the patient in a lab on that antigen/s, ensure antigen expression, and then replant the dendritic cells into the patient. That is innovative as it imitates the immune systems response to infection. Source: I worked in immune oncology for years…
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bilyl t1_ixvsbzk wrote
There are therapeutic vaccines and prophylactic vaccines.
Probably_a_Shitpost t1_ixxl1bb wrote
I used to put these exact vaccines together around 11 years ago. To get this vaccine, you had to have a had the cancer to begin with. A piece of the tumor is taken and combined with cells that will present a specific marker after. Ideally preventing reoccurrence by showing your body that it should attack any cells that present the marker ie. Cancer.
bored_in_NE t1_ixvhhlu wrote
"With well over 400 clinical trials for glioblastoma having failed over the last 15 years, it is gratifying to be able to offer new hope to patients who face this devastating disease."
This treatment offers a little more survival time but without the typical cancer treatment sideeffects.
In the Phase III trial of DCVax®-L, median Overall Survival (mOS) for newly diagnosed GBM patients (n=232) was 19.3 months from randomization (22.4 months from surgery) with DCVax-L vs. 16.5 months from randomization in the controls (HR=0.80, p=0.002). Survival at 48 months from randomization was 15.7% vs. 9.9%, and at 60 months was 13% vs. 5.7%. For recurrent GBM (n=64), mOS was 13.2 months from relapse vs. 7.8 months (HR = 0.58, p<0.001). Survival at 24 and 30 months post-recurrence was 20.7% vs. 9.6%, and 11.1% vs 5.1%, respectively. In newly diagnosed GBM patients with methylated MGMT, mOS was 30.2 months from randomization (33 months from surgery) with DCVax-L (n=90) vs. 21.3 months in controls (n=199) (HR=0.74, p=0.027).
EDIT: Removed line that was minimizing survival rate at 5 years.
DigitalParacosm t1_ixw0rz5 wrote
It’s more than doubling 5 year survival rates in the most common and fatal type of brain cancer. You cannot minimize these results.
PragmaticPanda42 t1_ixwtoby wrote
Thank you. High school boyfriend was diagnosed a week before his 18th birthday. He was death within 3 months. Five years (even one) would have meant the world to me and his family.
DigitalParacosm t1_ixwvubs wrote
So young. We usually see men in their mid 30s, but I remember hearing that if a patient is diagnosed younger than that: it can be very aggressive.
I’m so sorry to hear that he passed so quickly after diagnosis. Our patients usually had 10-12 months depending on how quickly their GBM was caught, and their immune response to treatment. Many patients had maybe 6 months to arrange and prepare for the patients death.. so I truly cannot imagine having only 90 days to prepare for the unpreparable.
bilyl t1_ixvsg0d wrote
A little? You’re understating it.
free-beer t1_ixwrf2f wrote
Oh geez guys. I know I'm late to the party and this is going to get buried but Northwest Bio (the company doing this research) is a well known fraud.
The study in question failed it's primary endpoints....so the company changed the endpoints....and threw out their control arm. The data presented here is compared to a cherry picked "historical control." To make maters worse, this trial has been done for years. The technology used here (dendritic vaccines) has just never lived up to the hype and is pretty old at this point.
All of this is basically unacceptable to the FDA, and this will never get approved, but that's not the grift these guys are involved in. Their scam is to just endlessly offer stock and pay themselves enormous salaries. They never want this program to complete. This trial in particular took over a decade with endless delays.
Do not trust this research. Do not trust this company.
Source: I've been an equity research analyst for the past dozen years and I have a PhD. I have no position in NWBO.
MRC1986 t1_ixwzzl0 wrote
Yep, this is smoke and mirrors. NWBO is a total scam.
beehive000 t1_ixxfo2p wrote
I wondered about this. My dad died from GBM in July, and we’d been watching NWBO for their ph3 results, which seemed to be taking forever to come in after the trial ended. We watched the initial presentation of the results before he died, I want to say sometime in the spring, and were not at all impressed by the results. I think it was just a couple months added to the prognosis, not anything different from the other experimental treatments out there. Was surprised to see this article represents the same trial, but published so much later.
This is a devastating disease.
Robbie1945 t1_ixxsxwg wrote
I’m a failed bio major but invest in some pharma stocks and my fiancé’s dad asked me about this company and after researching them and results I recommend he not buy in, he lost 30k. He’s a chiropractor so he thinks he knows medicine but he only believes in supplements and holistic stuff. He also lost 50k or more in Evoke because he wasnt happy with doubling his money.
HeebieMcJeeberson t1_ixw0hmo wrote
Glioblastoma is the really nasty one. I'm glad they're finally making some progress with it. My daughter was cured of medulloblastoma many years ago, but glioblastoma was incurable at the time. It's still the worst son of a bitch among kid brain tumors.
HoneydewHaunting t1_ixxtllk wrote
What’s her story if you don’t mind sharing?
HeebieMcJeeberson t1_ixxyev5 wrote
She was cured, but frankly it's not a happy story.
At age 10 she was diagnosed with a medulloblastoma after an optometrist noticed an enlarged optic nerve and recommended an MRI. Two weeks later she was in surgery, followed by 2 months radiation and 6 months chemo.
In a nutshell, the combination of surgery, radiation, chemo, and the tumor itself took a huge toll on her. She was an unbelievably great student, ahead at least 2 years in everything, a super-optimistic problem solver, with tons of friends. She ended up with balance problems, which eliminated ballet and other kinds of dance. Double vision and nystagmus made reading (which she LOVED) too difficult to be enjoyable anymore. She lost her exceptional math ability - which she really tried to regain but it just wouldn't come back.
Except for math her higher functions stayed intact - keen reasoning skills, a huge vocabulary and other things - but because of moving and speaking more slowly than normal, I think people underestimate her mind. She went through middle school and high school as the gimpy kid who couldn't keep up, so almost none of the kids talked to her - like ever - which was very depressing after being pretty universally liked at school. As an adult she has tried to take a few community college classes, but with low stamina and other problems she could only take one class at a time, and even then could barely pass, so she finally abandoned education and is physically not able to sustain a job. At age 29 she is on SSI and spends most of her time in a recliner watching TV and playing on her computer.
She has a few friends and does socialize a little, although her immune system is weak so she has been extra careful to stay away from people most of the time during this Covid crap.
tl;dr: she was a standout kid in every way, with unlimited potential, and basically the cancer and/or the treatments pretty well fucked her over.
Hope this didn't ruin your day.
Dizzy-Promise-1257 t1_ixy8oll wrote
Is there nothing they can do for now, seeing as it’s been nearly 2 decades, to improve quality of life?
HeebieMcJeeberson t1_ixy9l4s wrote
You mean for new patients or my daughter? She had the worst consequences they'd ever seen at Seattle Children's Hospital, so her case was an outlier. She was actually lucky to survive - her chances were about 50/50 at the time, but she got into a study for an experimental treatment using a small dosage of a breast cancer drug they thought would make the radiation treatments more effective. This turned out so well 17 ojut of the 18 kids in the study survived. Big improvement over 50/50. But as far as her quality of life now, she's getting the benefit of modern science, checking in with endocrinologists and taking various meds. But the damage has already been done. Fuck cancer.
honey_rainbow t1_ixvt8jh wrote
This is groundbreaking
Yogs_Zach t1_ixvw4jo wrote
I wouldn't say groundbreaking, but it's promising. It increases survival rate from 5% to something like 13% past 5 years. I think groundbreaking would be something like 20%, 30% or 40% or more
virtuesdeparture t1_ixvzm7d wrote
My dad died of GBM two years ago. Dcvax is nearly tripling five year survival rates after 20+ years of absolutely no progress in treatment or survival times. 13% might not sound like much, but GBM is a death sentence.
beehive000 t1_ixxf1s1 wrote
Agreed. My dad passed from GBM in July. I’m so sorry for your loss.
Yogs_Zach t1_ixxnk2x wrote
I'm sorry to hear that, and I didn't mean any disrespect with my comment.
I just think it would be prudent to temper expectations with this very deadly disease. Tripling the survival rate is wonderful, but from a statistical point of view the odds of survival increase by just 8% at the 5 year mark. Everything helps of course.
One of my biggest concerns is how expensive this treatment will cost and what insurance may cover it. From the article, it seems to be a very involved, customized, process. Many insurances may not elect to cover it if their cost/benefit analysis formulas show it's not mathematically viable for them.
Altruistic-Ad3704 t1_ixw0unj wrote
Can someone ELI5 how it’s possible to make a vaccine for something like cancer?
SirLeto t1_ixw9c5u wrote
You train immune cells to target the cancer.
Dizzy-Promise-1257 t1_ixy8ycw wrote
In a lot of ways our body is a wonderful, intelligent thing.
In a lot of other ways, it’s dumb as bricks and can be tricked into doing stuff like killing certain cells.
SalamandastronBadger t1_ixwpe0y wrote
My dad just passed away today from brain cancer. Sad this was not available for him but so thankful that it may be able to help others in the future.
tarheel0509 t1_ixwvoxj wrote
Sorry for your loss
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Joshartm t1_ixx5eg0 wrote
It… I don’t want to overstate this, but genuinely this is the news I’ve been praying for for the last 27 years… I lost my dad to brain cancer and he gave his brain to science in hopes that it could help lead to understanding or even a treatment.
I have no proof, but I want to believe my dad in his own way helped us reach here, him and all those who suffered and gave themselves to science… sorry I’m likely not making sense, just rambling and happy
kaytay3000 t1_ixxr2e0 wrote
I lost my dad to GBM 22 years ago. He participated in clinical trials for radiation wafers that were implanted in the skull. I understand that feeling of wishing that some good comes from his death. The trials along the way, whether successes or failures, have helped lead to new advances.
Your dad helped. And you sharing your experience helps.
KeyserWC t1_ixxfp3m wrote
So my dad has Glioblastoma and is faring decently well 6 months after surgery and post-chemo. Long term prognosis is obviously still bad.
Is this vaccine still a possibility for him and how do I get it? Any medical knowledge available around how we could grant a waiver to allow him to try this?
[deleted] t1_ixvnco9 wrote
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FuckyWiring t1_ixwkc3j wrote
I really hope they do a trial for low grade gliomas as well.
VollgasJen t1_ixwnx7m wrote
Is this the same vaccine that is on trial for breast cancer? There is an astounding story of a woman struggling with 20+ years of metastatic hormone breast cancer that has seen a dramatic decrease in tumor size after a round of vaccinations.
A_Shadow t1_ixwtyqu wrote
Nah, likely different. You would need a different vaccine for each type of cancer.
[deleted] t1_ixwzmn0 wrote
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Sn336168 t1_ixxdvhg wrote
I like this. Anyone else like this?
beehive000 t1_ixxed3u wrote
My dad died from this in July :(
OP_Giddy t1_ixxf3qb wrote
Love and hate story as I watched my sister die of glioblastoma but I truly hope this can save those who have this truly debilitating disease. It ruined my family.
Delishus_Frosting713 t1_ixxffyf wrote
Wow is this legitimate?
anslew t1_ixxha33 wrote
Didn’t know brain cancer was a virus
Lmao
[deleted] t1_ixxi24s wrote
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Teamnoq t1_ixxo8h9 wrote
This is great news!
LordRiverknoll t1_ixxru9m wrote
We’re getting there! Cancer might just be cured in our lifetime
GWtech t1_ixychm8 wrote
I hate to be a downer but if you've ever known anybody with cancer who's passed away from things like this you know that those months of prolonged life are filled with doctor visits and the terror of whether or not your treatment is working.
And even if the side effects aren't bad the mental trauma that the patients are going through as they get a treatment that might give them a chance that they're hoping for a cure from that they have to then wait a month to see if they're going to get a cure or reduction in their cancer leaves them basically on pins and needles for the remaining months of their life.
No, I'm not saying it's wrong to have these treatments because certainly every scrap of life that you can claw back is important to people who are dying and I have no doubt that if I was in that situation I would probably scrap for every moment of life as well.
But what I am saying is when something says that a treatment prolongs life for months or even a year it's wrong to think that people are taking a treatment and then they're having a wonderful life for those months or years. They arent. They aren't getting their old life back. They're entering into some weird new nerve-wracking state of existence filled with Hope and dreams all pivoting on the next doctor visit every single week or month that this goes on. If I was diagnosed with cancer if I had the courage and the smarts I personally think again if I had the courage the wise thing to do really would be to take whatever last vacation trip or do whatever thing you really wanted to do before you died and enjoy that last period of time rather than fighting for a few extra months under those other circumstances.
There are certain cancers that they absolutely have been able to cure now and that's certainly worth doing. But these treatments that only promise a few months of extended life are in retrospect probably not the best way to spend the last few weeks or months of your life.
Wonderful-Hour-5357 t1_ixyvvhx wrote
Wow you are so brave to say this I always thought the same way of course I never had cancer but I think I don’t want the he’ll these poor suffering people go through fuck cancer
GWtech t1_iy98w20 wrote
Had a few people die of cancer in my arms. Heard all the doctor stories. All the talk about brand new treatments and experimental treatments and trying to get into the latest new treatment that in the 6 months that you're diagnosed with cancer might just possibly be different than all the other experimental treatments that have been going on for the last 40 years that didn't do much. I mean they have had some success. But it's just cause me to be very skeptical.
There been some huge breakthroughs I think like gleevac for some forms of leukemia which is apparently just been a effortless cure and a pill and there may be some others I'm not aware of but I don't know. Things like prostate cancer and colon cancer if you catch them early or almost trivial now so catching things Early is important.
Anyway that's all I know. I'm not a doctor and it's not medical advice it's just my own personal thoughts.
I'm also met two people who have survived pancreatic cancer which used to be a certain killer so they're apparently some treatments now little take care of that so it just depends on when they're diagnosed and you got to do a lot of research and find out what really works.
GWtech t1_ixyd2vt wrote
I remember a study how glioblastoma's were caused by extensive dental X-rays in young children. These manifested in brain cancers decades later.
Don't listen to all the banana cancer radiation comparisons. True studies have shown that for every increase in radiation that you're exposed to there's a proportional increase in cancer. So small amounts of radiation including even dental X-rays increase your risk of cancer by a similar small amount. But extensive full skull around the head dental X-rays to detect early cavities in teeth that are going to fall out anyway are absolutely extraordinarily irresponsible. Let your kid get the cavity and have it filled when they get the cavity if they need to. Do not let a dentist fill your kids mouth and head with radiation for something as stupid as that.
Relevant-Ad2254 t1_ixz0a58 wrote
Immunotherapy is miraculous. My fiancé was getting wrecked from chemo, but now she’s only on immunotherapy and has almost no side effects. She’s able to live her life again.
For all those dealing with cancer, please make sure your cancer gets tested for biomarkers that can be targeted. Targeted therapy is a gamechanger
NoahCharlie t1_ixz7flb wrote
It's great to hear this!
No_Formal_8697 t1_ixzk5x7 wrote
If everything has a frequency then all cells have unique frequencies. Find the frequencies, find the anti frequencies, cure everything.
No_Formal_8697 t1_ixzkh82 wrote
Use nanowire/ particles to selectively target the cells. Bring the battle inside.
Slow_Butterscotch382 t1_iybf0u4 wrote
What's in it? Who sponsored this ? Is this the next mandated shot?
Nexo_Ace t1_ixwo0kv wrote
One of the trials was probably browsing through Twitter.
JaxckLl t1_ixx5xf0 wrote
A) It’s not a vaccine if it’s directed towards cancer, as cancer is not a viral body.
sharkeymcsharkface t1_ixxcil2 wrote
Vaccines trigger certain T cell responses - they can be directed toward just about anything, viral or not.
nathiyadl t1_ixw98z6 wrote
Mutation here we come
tarheel0509 t1_ixwvtec wrote
Cancers don’t spread from person to person so it doesn’t matter
GWtech t1_ixycvke wrote
Actually there are several cancers that are viral based. One of the most well-known ones afflicted AIDS patients who after they got the AIDS virus ended up getting very noticeable distinctive unusual skin cancers called some kind of sarcoma. I forget what it was. When AIDS was first happening in the 1990s I remember very well the discussions that this caused a cancer that was contagious and it was the first known type of cancer that was contagious. Now you don't need to tell me that the cancer wasn't directly caused by the virus. I know that. The virus reduced your immune system which left your body open to the cancer. Nonetheless the cancer itself was contagious because of a virus.
The other contagious cancer I know of is the well-known cancer that young girls are being told to get vaccinated against. It's the uterine cancer caused by that HPV virus.
A_Shadow t1_ixwudba wrote
That's going to be the case with any cancer treatment with the possible exception of high intensity chemotherapy.
[deleted] t1_ixvhxmz wrote
I've watched two people die of cancer, maybe extending you're life at that point isn't what you want.
Edit - I'm just bitter atm
twofortomatoes t1_ixvxyzu wrote
Maybe speaking for all cancer patients after only knowing two isn’t what you want.
virtuesdeparture t1_ixw06yl wrote
Dcvax extended progression free survival rates even for recurrences. I’ve also watched two people die of cancer, both extremely aggressive (one GBM). He had a 99.9% resection of GBM and he did well for about six months until the cancer reoccurred.
DigitalParacosm t1_ixw15me wrote
Maybe it’s not what you’d want, but this treatment is offered well after you’ve been offered palliative care and hospice services, so your point is moot at best and incredibly cynical at worst.
Relevant-Ad2254 t1_ixz0ltv wrote
Depends how you prolong their life. Targeted therapy like immunotherapy gives a lot of virtually no no symptoms since the treatment only attacks cancer cells
[deleted] t1_ixvttch wrote
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Argonaut13 t1_ixvuqmd wrote
Yeah we should just make drugs to kill them all faster I guess
ophelia_jones t1_ixwi346 wrote
My mom lived six months longer than anyone else in her clinical trial cohort when she was dying of brain cancer. Not a single doctor in her research hospital cared about how they were going to make money off of a penniless, dying cancer patient. They were just trying to help. I know it's easy to be bitter and jaded with our Healthcare system, especially when you've lost someone you love horrifically, but this "they make money by keeping you sick" narrative does researchers such a disservice and isn't true.
Jedmeltdown t1_ixvdx96 wrote
I thought we weren’t supposed to trust scientists or is that only global warming scientists?
PragmaticPanda42 t1_ixwumy7 wrote
Who told you that and how old are you?
Global warming is real. The earth is round (ellipsoid if we're being pedantic). Vaccines don't cause autism.
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basednyourfknface420 t1_ixvel25 wrote
And that’s all they want .. they could cure it by where’s the money in that? They’d rather keep you sick and dependent on there drug to stay alive .
TyNyeTheTransGuy t1_ixvf34l wrote
Begone, conspiracy theorist.
pterodactyl_balls t1_ixvvmnr wrote
What’s the conspiracy?
Sigmundschadenfreude t1_ixvyjie wrote
The assumption that cure is being suppressed. This conspiracy is usually peddled by mental gnats who have no idea about the complexities of cancer biology
pterodactyl_balls t1_ixwb8oj wrote
A conspiracy is an agreement between two parties to commit an illegal act. What part of the alleged 'suppression' constitutes an illegal act?
Tibetzz t1_ixwe9ym wrote
the definition of the criminal act "conspiracy" is not relevant to the cultural definition of a "conspiracy theory", which is not always criminal and is always something that is being covered up.
A_Shadow t1_ixwuowl wrote
For his "theory" to be correct, it would have to an agreement with all the drug companies in world to suppress the one cure for cancer.
unripenedboyparts t1_ixvgb58 wrote
>where’s the money in that?
Well gosh, I always thought insurance was this huge racket but then some genius at the bottom of a Reddit thread used poor grammar and punctuation to allude to this conspiracy while never quite explaining it, and now I realize that only drug manufacturers are wealthy enough to suppress a cure for cancer.
Poor BCBS.
basednyourfknface420 t1_ixx4jjc wrote
What you just wrote is incoherent. There’s nothing to respond to . Make sense and maybe I will own you . Pompous overtone did come through but the ignorant rant really lost connection with the reader
Even-Willow t1_ixvw0iw wrote
I hope you get the help you deserve one day there buddy.
basednyourfknface420 t1_ixx4q5n wrote
Your an excellent chime in er lol now go get your 4th booster . Your so agreeable it’s adorable. Your gonna agree your way right into a WEF cage
doc_long_dong t1_ixw2dyq wrote
You’re a fucking idiot
[deleted] t1_ixx3wbr wrote
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DigitalParacosm t1_ixwecf1 wrote
The company who made this drug is small and isn’t getting any favors from the FDA in its approval process. You do not know what you’re talking about.
basednyourfknface420 t1_ixx3zjf wrote
Who funds the studies ? Nih? No problems there haha have you been boosted yet? You should get it again I hear that’s going very well.
DigitalParacosm t1_ixxa8uv wrote
“Who funds the studies? NIH? No problems there haha have you been boosted yet? You should get it again I hear that’s going very well.” -basednyourfknface420
That’s easy information to Google but I’ll help you out.
The drug, DCvax, was authorized to be used on anyone who could make it to Germany, not just for Germans but if you flew your ass to Germany with a glioblastoma, they would give you this vaccine as early as 2015. Easily a $200k treatment.
Germany’s toughest medical regulator, PEI, gave them a hospital exemption to administer this drug to patients who were in what you could call a terminal ward. That was like 7 years ago, man.
Germany is a country that rightfully laughs at our private medical corruption, and instead, they direct their resources to finding innovative treatments for their people. PEI only invested after the drug after it performed well in a hospital setting. I want you to imagine how a healthcare system could work without private corruption from insurance/big pharma. This country invested in this drug after presumably seeing it work in a very fucking grim setting. Imagine patients dying every 7, 30, 60, 90 days and now suddenly *they’re not * kind of shit.
Why would Germany offer to give a 200k therapy to not only their people, but foreign nationals as well? They have a healthcare system that works for their people, not a broken healthcare system that requires their people to die for it.
The conclusion we’re left with is either Germany spent millions of dollars to murder not only dying Germans, but everyone already dying with the most sinister brain tumor in the world, or, they’ve got a healthcare system that is agile enough to invest and deliver breakthrough medications to their people, and the world.
I’ve seen these patients die 10 months from diagnosis, and really the best we’ve got is a drug called Temodar which is like super-chemo injected into a reservoir anchored into your brain. If there is another option than that: sign me the fuck up.
Do you know what chemotherapy does to you? An oncologist once told me “i just give people poison.. and sometimes it works” - it’s a dark joke, but it accurately portrays the ineffectiveness of chemotherapy. He likened it to hammering a nail into your door frame with a sledgehammer, we got the mail in there fine, but we fucked your frame and door up in the process and the door might not quite close now. Chemo is the weatherstripping. he is not wrong. Chemotherapy isn’t targeted like these treatments are.
Why don’t you be anti-chemo, then you can sound smart instead of insane. You’re not safe from spreading disinformation on a technology subreddit: there are medical professionals here.
Tibetzz t1_ixwewq2 wrote
To be clear, you believe that the pharmaceutical industry is so hyper-competent that they can cure all illnesses with a single course of treatment, but they are too incompetent to turn that cure into a lifetime monthly subscription?
basednyourfknface420 t1_ixx4adb wrote
Hyper competent? Your just ignorant to what they’re capable of. You know the elite are out spoken depopulationists? The ones who made the vax you took .. yeah they think there are too many people and they thinks it’s an emergency.. you should really read your leaders writings ( Klaus schwab) agenda 2030
Tibetzz t1_ixx5s3q wrote
How is any of that relevant to the topic? We were talking about where the money was, and how the elite can keep you dependent on their drugs to stay alive.
So again. You believe they have the ability to cure any cancer, but they won't do it because they can't make money off of healthy people who don't need their products. However, if they can cure cancer, they can easily make that cure into a monthly prescription for the rest of your life, to keep you cancer free.
Let's weigh the options for the elites who own us.
Don't Cure Cancer:
-People buy your products, somewhere between some and most of them die in a few years and stop buying your products.
Cure Cancer:
-Patients live the longest possible lives, buying your product the whole time.
-You literally control whether any cancer patient dies of cancer.
If anything, if they announce a cure for all cancer, that's when it's time to get worried about the pharmaceutical cabal.
basednyourfknface420 t1_ixx9w76 wrote
Yes I’d be willing to bet they can , see the head of the nih is a depopulationist, nih protocol was put in place to kill people and inhalers and ivermectin were told it to use. So use that instance and ask yoursef if they would to that do you think they would keep a cure for cancer from you? A depopulationist? Just like hiv they have drugs that make you undetectable but not cured , wouldn’t that be more difficult? The can edit your genes to. It get cancer( crisper) why would you think they couldn’t?
Tibetzz t1_ixxb2nf wrote
I'm sure they could, however I am quite confident that everything you've just said is only plausible in a bad film plot, whereas in the real world the global elites control everything through very conventional means, as well as have goals that actually make sense and benefit them in some way.
[deleted] t1_ixw28k0 wrote
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[deleted] t1_ixuoljq wrote
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stupidusername15 t1_ixuqig0 wrote
Vaccine is when you recruit your own immune system to fight against something. This is the correct usage.
MrFeature_1 t1_ixuxsr3 wrote
And first and foremost - neither do you
runtheplacered t1_ixv5qq7 wrote
Confidently wrong, the worst kind of wrong.
Halt-CatchFire t1_ixv7a5a wrote
Gosh wait until you hear about the rabies vaccine you're gonne be so peeved.
Chemical-Hot t1_ixv2nw4 wrote
“ prolong” what? profits and suffering?
henshaw111 t1_ixv4kpj wrote
Aside from getting valuable time with their families, doom and gloom aside, anyone with cancer - or any life limiting condition, I suspect - there is always hope that there’s something ‘just around the corner’. A few people I know have benefitted from treatment that was in its early days and not widely available, IIRC, and treatment nowadays appears to be far less brutal than in the days of chemotherapy in the 70s, 80s and earlier when my father (brain tumour, actually), one of his brothers, and probably the majority of the rest of his siblings and several family friends were diagnosed with cancers of various sorts.
Folks can always refuse treatment, and some do.
addiktion t1_ixvduns wrote
My wife's mother refused treatment and surgery wasnt really an option. She couldn't really talk with us as her speech was greatly impaired and felt like there was no point spending several months in that state given speech was one of her gifts in life.
I'm sure if she caught it sooner and something like this was available that could prolong the good parts of quality of life it would have been a different story.
Chemical-Hot t1_ixv6jdb wrote
Not every case is the same but these “ advances” kept my stepdad alive much longer and he was in terrible pain and in and out of hospitals the last year of his life. He got more time, more pain and a brutal exit from this world.
henshaw111 t1_ixvaazm wrote
‘Not the same’ is exactly the point, which is why cynicism isn’t helpful. In the earlier days of chemotherapy it was pretty much the case if the cancer didn’t get you, the chemo did - and the side effects were pretty unpleasant. Palliative care has inevitably improved over the decades. With a lot of cancers, people eventually run out of road and the last several months or more can be pretty shitty. At the moment I’ve a couple of friends, one with stage 3 bowel cancer, another with prostate cancer. Both have metastasised, they’re into the realm of whack-a-mole, hope, and not heading out of the door just yet.
Foryourconsideration t1_ixvsjmx wrote
I think more people need to read The Emperor of All Maladies
H2AK119ub t1_ixv2z62 wrote
A total of 331 patients were enrolled in the trial, with 232 randomized to the DCVax-L group and 99 to the placebo group. Median OS (mOS) for the 232 patients with nGBM receiving DCVax-L was 19.3 (95% CI, 17.5-21.3) months from randomization (22.4 months from surgery) vs 16.5 (95% CI, 16.0-17.5) months from randomization in control patients (HR = 0.80; 98% CI, 0.00-0.94; P = .002). Survival at 48 months from randomization was 15.7% vs 9.9%, and at 60 months, it was 13.0% vs 5.7%. For 64 patients with rGBM receiving DCVax-L, mOS was 13.2 (95% CI, 9.7-16.8) months from relapse vs 7.8 (95% CI, 7.2-8.2) months among control patients (HR, 0.58; 98% CI, 0.00-0.76; P < .001). Survival at 24 and 30 months after recurrence was 20.7% vs 9.6% and 11.1% vs 5.1%, respectively. Survival was improved in patients with nGBM with methylated MGMT receiving DCVax-L compared with external control patients (HR, 0.74; 98% CI, 0.55-1.00; P = .03).
[deleted] t1_ixvdgjy wrote
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[deleted] t1_ixur530 wrote
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throwawayagain31 t1_ixusu56 wrote
I don’t know anything about this publication, but if this data is correct, this study is pretty incredible. GBM typically has such a bad prognosis and the fact this therapy is a phase III trial with these results (Little to no SAEs associated to drug + significantly buying months of life compared to randomized control) appears to be a big deal. At this point with GBM research, the goal with any GBM drug is just to try to buy just a few months more of life for the patients. At first glance the study design is fine.
I’d also mention that most GBM trials right now at cancer centers are studying immunotherapy drugs that are much unlike this one, they attempt to prevent the growth of GBM via other mechanisms so this seems a very unique therapy. That would make it appear to fit in on this sub to me, but idk.
sirbissel t1_ixuz8gk wrote
The study was originally published in JAMA Oncology, and looking over the Biopharma Reporter page, it seems fairly credible.
H2AK119ub t1_ixuv0h5 wrote
IO therapies have all bombed in GBM. GBM tumors are distinct to other cancer settings where IO has succeeded - eg., heme (ie, CAR-T) & inflamed tumors (anti-PD(L)1 mAbs). This one is interesting in that it uses the heterogeneity of the tumor itself (tumor lysate) to "educate" the immune cells (DC's).
throwawayagain31 t1_ixuwiu0 wrote
I agree. My opinion has turned to the idea that most GBM pts (and perhaps lower grade glioma) need more specificity in treatment because of the flexibility of glial material in the brain it’d be difficult to lockdown the root cause. A checkpoint inhibitor is not going to be the end-all be-all. It’s like patching one hole in an old boat at sea in the midst of a storm hoping you won’t spring another. The availability of promising GBM IO drugs is certainly depressing, but it’s definitely cool to hear about something making a difference with this level of disease for once. That being said, I haven’t read through the peer review of the study yet.
H2AK119ub t1_ixuy1j6 wrote
I don't really understand your points. Current IO therapies don't work in GBM because it is a very heterogenous tumor type (not clonal like heme is) and there are few T cells in the brain for the MOA of checkpoint inhibitors to work. TAM reeducation is the closest a generic, non-personalized IO therapy could have for a decent shot on goal in this indication.
throwawayagain31 t1_ixv1cz0 wrote
Great points. I make some assumptions not really based in much research about glimpses just from personal experiences. You’re right in that it is a generic approach but it is wholly personalized from the POV that it’s utilizing the specific patient’s cells.
MisterIceGuy t1_ixvjy18 wrote
Originally published in JAMA.
https://jamanetwork.com/journals/jamaoncology/fullarticle/2798847
DigitalParacosm t1_ixwersk wrote
Where’s the ad? This drug has been developed through clinical trials starting in 2008.
Just because you don’t understand or care to understand the significance of this doesn’t make it not breaking news.
H2AK119ub t1_ixuum3x wrote
An interesting study and a long running one (this study started in 2007 and finished recruiting in 2017). "Educating" dendritic cells with tumor lysate to give them "memory" to go and attack tumor cells. I'm not a fan of the controls (historical, external) or the study design (cross over) that were used in the trial but you can make a strong case that a placebo arm is unethical in GBM or any recurrent high grade tumor. Data are promising; this could be the first treatment to be added to frontline care in high grade gliomas after nearly two decades of failed trials.
https://jamanetwork.com/journals/jamaoncology/fullarticle/2798847