Northwest Biotehrpeutics: How Does DCVax-L Clinical Data Compare To The CAR-T Therapy Axi-Cel?

An article on Seeking Alpha called Northwest Biotherapeutics: Statistically Satisfying was just published by an author who uses the pseudonym Bohsie. He looks at the unblinded data from the phase 3 trial of DCVax-L and hypothesizes that the data seems highly supportive of the hope that the phase 3 trial of DCVax-L will be statistically significant on the primary endpoint of PFS. The article is balanced, insightful and well-reasoned, but as is always the case, writers from hedge funds have viciously attacked the article. The common thread of their comments seems to be that the trial will fail because the stock price is $0.18. None of the numerous posts attacking Bohsie tried to refute his analysis. They just attacked him personally. This is a standard tactic of hedge fund shills.

Hedge Funds Disparage the Article

Hedge funds have been heavily involved on the long side with KITE and for some time I have thought about comparing the phase 2 results for KITE’s CAR-T therapy Axi-Cel versus phase 1/2 results for DCVax-L. I finally did this in response to one of the hedge fund writers Biotech Hawk. This author (probably a consortium of hedge fund personnel) published four highly negative articles on NWBO from July to October of 2014 and then disappeared only to reappear and make comments on Bohsie’s Seeking Alpha article. The four articles were done at a time when there was a widespread short selling attack on NWBO. Anyone want to guess which hedge fund he works for? Anyway, Biotech Hawk in attacking Bohsie praised the data from Kite’s CAR-T drug Axi-Cel. His  comments personally atttcked Bohsie without any attempt to refute the article with meaningful data. Two of his comments are shown below

Comment 1 from Biotech Hawk:

You assume that NWBO is publishing correct information. They have a history of manipulating or misrepresenting data in the past.

You assume NWBO management is competent in running or analyzing clinical trials.

You assume that the PFS data released are accurate. PFS is a subjective measure and it is not clear if NWBO is doing independent analyses of progression, their own interpretation, or using investigator judgement.

You assume that the 83 patients are not just lost data (e.g. patients that had disease progression years ago, but the data has not been entered in the database).

Why, oh why, has it taken more than 6 months to release the results of the trial. The study primary endpoint is at 248 PFS events. That was reached in February. In 20+ years of running clinical trials, I have never seen an analysis take so long.
I once had a short position in this stock and exited that position almost 2 years ago. I have no dog in this fight, except that it pisses me off to see obvious frauds still in existence giving people false hope.

After writing negative articles about NWBO several years ago, I received several emails from thankful people who sold out of the stock. Take my advice for what it's worth. Save yourself the last 20 cents / share

Comment 2 from Biotech Hawk:

KITE filed a BLA a few months ago and is likely (though not guaranteed) to have a product FDA approved by the end of this year. Their pivotal trial took 2.5 years to complete. Because they are competent and their product works. I am sure that if data were positive, NWBO would have wasted no time to PR the results soon after the trial met its endpoint in February.

My Response to Biotech Hawk

I have pointed out in numerous past articles that it is a paradox that people can look at the Kite phase 2 data on Axi-Cel and pronounce it as stunning as does Biotech Hawk and in the next breath dismiss phase 1/2 data on DCVax-L that appears much more encouraging. Biotech Hawk’s provocative nonsensical comments caused me to take pen in hand and respond to him in the Seeking Alpha article. I thought I would reproduce this comment for my subscribers.

KITE's ZUMA-1 trial was an open label phase 2 trial of Axi-Cel that evaluated 71 patients with r.r DLBCL and 41 patients with r/r PMBCL and TFL. The r/r DLBCL results are most important since in an addressable market of about 7,500 patients r/r DLBCL patients comprise over 6,800. Also r/r DLBCL patients do less well than r/r PMBCL and tFL patients in whom results are meaningfully better.

Let's focus on the r/r DLBCL results. At six months, there were 33% of patients who had a CR that was maintained. There is no data on survival. Will a CR translate into long term survival? We don't know. Shrinking tumors is suggestive of improving survival outcomes, but very far from definitive.Results in pediatric r/r ALL suggest that CRs translate into long term survival, but we don't know about r/r DLBCL. There is no data.

Biotech Hawk enthusiastically endorses the ZUMA-1 results, but disparage the extremely positive results of the phase 1/2 trial of 20 newly diagnosed GBM patients treated by Linda Liau at UCLA. In those 20 patients median OS was 3 years, median PFS was 2 years and 33% of patients were alive at 4 years, 27% at six years and 2 patients have survived for more than 12 years. Well controlled clinical trials have shown that 10% or so of newly diagnosed GBM patients treated with SOC are alive at three years.

I would have to say that the average new investor from Mars would without question, consider the DCVax-L phase 1/2 results extremely promising and the Axi-Cel results as interesting, but needing to mature. They might also wonder about pricing Axi-Cel at $500,000+ per treatment when only one-third or less may benefit. By the way, about 30% to 40% of Axi-Cel treated patients suffer grade 3 or 4 side effects while the side effects of DCVax-L are a headache and fever that can be treted with Tylenol.

Perhaps some of the brilliant mathematicians and biostatisticians who work for hedge funds can explain why the Axi-Cell results should be considered as superior as you maintain. My Martian friends and I are baffled by your claim that Axi-Cel phase 2 data as we now know it is so superior to the phase 1/2 DCVax-L. Oh I forgot, the data reported by Linda Liau is fraudulent and she and the UCLA neurology department are engaged in a conspiracy with NWBO to defraud investors. Linda Liau has reported that she does not own any shares of NWBO so her motives for engaging in stock manipulation as you maintain are difficult to ascertain.

I think that CAR-T therapy is a significant advance in oncology, but at this point all of the survival data is anecdotal from NIH and UPENN and there is absolutely no data from controlled trials.

I for one think that unblinded data on the controlled phase 3, DCVax-L trial of 331 patients is extremely encouraging as patients are undoubtedly living longer than would be expected with SOC. Of d course, no one clearly knows what is going on until the trial is unblinded. I have written a report on this on my website, which I encourage all to look at. Whereas Bohsie focuses on PFS, my focus is on OS. Here is the link.

Disclosure: None.

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