CDX-110 versus DCVax

Hi all,

We were notified today that Mom qualifies for both of these trials.  We spent about 4 hours at the oncologist's office asking questions and weighing the options.  It seems as though the CDX-110 would absolutely be the way to go IF it had the crossover arm and she would be guaranteed treatment if she regressed.  However, with the crossover guarantee the DCVax is pretty appealing.  I'm interested to hear some of your thoughts of the two options.  If you had to make the decision, which would you choose and why?

On a side not, I have been overwhelmed and so very humbled by all the people who reached out to me after I posted about my mother's new diagnosis.  I know that I owe an update and I will do it soon! It's been a busy week that has offered a lot of answers.  I can't begin to explain how much your guidnace has helped me find my footing.  It's nice to know that there is a kinship available with others going thru this... even if you hate that any of us are going thru this!

 

Angela

dear angela,

it is nice to hear that your mum is able to choose between two possible trials. What factors make you think that CDX-110 is superior to DCVax? Did you compare the progression free survival & overall survival data of the prior clinical trials of the two vaccines? as to my knowledge DCVax is still far superior according to those published figures.

An other advantage you point out is that you can cross over in the DCVax trial, which from a patient's point of view is a great advantage taking part in a trial.

All the best for your mum and hope her treatment can start soon.

please also visit milesforhope.org . Maybe when you contact them, they can help you make another independent opinion about which trial you should choose for your mum

Angela, it's great your mom qualifies for these trails. I'd probably want to base a decision on what specific mechanisms each vaccine targets and whether your mom's tumor expresses those mechanisms. (For example, does it target EGFR and does your mom's tumor express EGFR.) Trouble is, that may not be known yet. But you could ask your N-O.

Angela,

You have two options for the trial which is great news. Both vaccines have benefitted patients.The only difference I see is prior clinical trial results for DCvax has been significant and having the crossover arm with disease progression is a positive. I found the prior data from the DCvax trial which I have enclosed below for you. Hope this helps and good luck with your mom!

Northwest Biotherapeutics, Inc, announced longterm follow-up data for the second half of 2008, from its prior phase I and phase I/II clinical trials with DCVax-Brain in patients with glioblastoma multiforme.During the update period from June 15, 2008, through January 1, 2009, none of the 20 patients treated with standard of care plus DCVax-Brain died. So far, 68% of patients treated with DCVax-Brain have lived more than 2 years, 63% have lived more than 2½ years, 53% have lived more than 3 years, 35% have lived more than 4 years, and 25% have lived more than 5 years.In contrast, patients who receive full standard of care (surgery, radiation, and chemotherapy) without DCVax-Brain have a median survival of only 14.6 months, and less than 5% of these patients are typically alive at 5 years.

In addition, only 2 of the 20 patients experienced progression or recurrence of their brain cancer. One of these two patients had been disease-free for nearly 6 years at the time of their progression, and the other patient had been disease-free for more than 4 years. The usual time toprogression in glioblastoma, with full standard-of-care treatment but without DCVax-Brain, is only 6.9 months.

Angela, the above poster has never made any comment on this board on any topic other than DCVax.

I'm glad I asked this! So, here is my understanding so correct me if you understand differently: My Mom does have the EGFR mutation which is why she qualifies for the CDX-110. It is my understanding that patients with that mutation have less favorable recurrence rates and life expectancies than patients without that mutation. Therefore, although both vaccines have similar overall recurrence and survival rates that the CDX vaccine had more work to do (so to speak) to get the patients in that trial on par with those in the DCVax trail. Does that make sense? Our oncologists definitely said that if Mom could be guaranteed to CDX vaccine that it would be the way to go. I think that he feels like the longer term/ larger scale results of Celldex will start to surpass DCVax and that the future of vaccine therapies will be more targeted like Celldex instead of more global, like DCVax. I think Mom is leaning toward DCVax. From what we understand there is actually a trial of Celldex for recurrent cases that she could potentially do down the road if DCVax doesn't do what we hope. Wash U is also doing a TVax trial for recurrents too. I think I'd prefer her to do DCVax also. I'm just not excited about her basically flipping a coin on Celldex when tumor regrowth for EGFR patients is closer to 4-6 months. I think I'd prefer the strongest first line defense we can give her and then try these other things when the time comes.

On Jun 16, 2012 3:31 PM siblingof wrote:

Angela, the above poster has never made any comment on this board on any topic other than DCVax.

Ahhh, gotcha. Thank you- I really want real people answers. I'm not stupid- I can read the research myself. Someday I will care about the science behind all this and the ultimate good for humanity. Right now I'm just trying to keep my Mother alive and capable for as long as I can. Forgive me if that makes me selfish, but I could care less about DCVax except for whether it's the right choice to keep my Mother here for as long as possible! We know that we are lucky to have TWO options that so many don't, but since we do there's a lot of anxiety in making the right choice.

dear angela, you are right. the only focus in this process is your mum and your family. i was confronted with prostate cancer some years ago and was in the same situation like you.

We tried out many different and last resource early research stage medicine in the area of stem cell research here in switzerland. Unfortunately my dad reacted allergically to it and we nearly lost him giving him this medicine.

What helped me most was to get second and third independent opinions. Maybe if you have time this would help you and your mum as well to make the best choice for your mum.

Quick question: what is a crossover arm? Thanks, Ravi