Carlo Rago, PhD Profile picture
Feb 2 4 tweets 2 min read
This draft guidance is wonderful in that FDA reminds us that there has been a long-standing precedent (decades) for use of external controls as "substantial evidence of effectiveness" and approval.

But is it relevant?...

fda.gov/media/164960/d…

$NWBO #Murcidencel Glioblastoma Image
This draft guidance is focused on "patient-level data" which might not relate to #Murcidencel - In that case, FDA would be able to cite the decades old precedent.

Recall that Avastin and Optune were both FDA approved but didn't improve survival in rGBM, unmet need.

$NWBO Image
In summary, this draft guidance is overall positive for $NWBO as it
1 shows FDA flexibility and precedent for use of external controls as substantial evidence of effectiveness
2 aims to formalize a portion of the precedent into official "guidance" for industry
$XBI Cancer Vaccine
See Smith on Stocks below for a similar but different POV - He suggests the new draft guidance is very positive for use of historical controls, particularly in orphan diseases like GBM.
$NWBO
smithonstocks.com/northwest-biot…

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More from @rago_carlo

Dec 29, 2022
Combo data, combo patent.
$NWBO #Murcidencel
$MRK $BMY etc
CIs didn’t work, so synergy is *non-obvious*

Further, IF ANYTHING, field was maybe suggesting that neoadjuvant was only place it might work. BUT *unexpectedly* adjuvant works best.

Patentability = war, highly competitive, highly lucrative CI market

$NWBO $MRK #PD1 #Checkpoint
The combo data reduced this non-obvious, unexpected phenomenon to practice, in my opinion.

1 + 0 = 6

$NWBO $MRK
Read 4 tweets

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