Yes, I think that is unknowable really. We just have to wait and see.
has just made a good point about IV probably being higher - and I certainly agree with that. One of the things in the recent early results data announcement for Vaxinia which leaped out at me was that a patient with Bile Duct Cancer achieved stable disease
with Vaxinia.
In the preclinical studies, IV treatment worked in mice but it does take a higher dose than direct injection to the tumour (presumably because it has to circulate around the whole body, so only relatively low doses actually reach the tumour) - and friend Slykes is probably correct that we will end up with two OBD's.
Effectiveness with IV (and indeed intra-peritoneal injection, which they have also experimented with in animals) is incredibly exciting because it offers the hope of knocking out metastatic cancer wherever it may have spread in the body. That would include lesions which were previously undiscovered and unknown.
One patient with stable disease is not "proof" - but to see a patient achieve stable disease on IV treatment (in a very hard to treat cancer type) - and at relatively low doses - is certainly a very encouraging "signal." (Not to forget the complete response on Bile Duct cancer for a patient with direct injection to the tumour).
There is a lot happening here, and because they were required by the FDA to start at very low dosages ("teeny tiny" was the term Yuman used), and enrol in a slow staged fashion, the first results have taken quite a while. However, there is an analogy that runs through my mind which helps me maintain patience:
I think of cooking popcorn on the stove for my kids, quite a few years ago now, in a big old saucepan with a glass lid.
Add some oil. Tip in the corn. Turn on the hotplate.
Nothing happens.
Nothing keeps happening.
The kids are getting restless.
They are standing on chairs to get a view.
Youngest child pinches the eldest one to get a reaction
Eldest child asks the cook (me) if I really know what I'm doing!?
They are now both so bored that they threaten to simply leave the kitchen ....
(If this behaviour sounds familiar - we have seen the adult version of all this on Hot Copper recently)
And then....
POP!!! ......POP POP!!! .....POP POP POP POP POP POP POP POp POP POP POP POP POP POP!!! . And suddenly, everyone is happy again....
It may not be an exact analogy, but turning up the dose is a bit like the build up of heat in the popcorn. At first, nothing seems to happen, but then it does start to happen and - if the recipe is right - that first "Pop" is just a signal of good things to come.
If Vaxinia works as expected, there is a bell curve here, and the first responses are the people at the thin left hand side of the curve.
We have no way of knowing for sure if that kind of success is happening, but it could be happening right now.
It alway starts with just one:
VIDEO VIDEO Cheers
Dave
(20min delay)
