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In 2007, an 17 member FDA advisory panel of experts voted overwhelmingly to approve Provenge, Dendreon's prostate cancer immunotherapy biologic agent. The panel voted that Provenge is safe and effective. Subsequently two of the doctors on the panel who unbelievably had received wavers from FDA of their conflict of interest -- and there is debate whether they disclosed all their conflicts of interests, rallied against Provenge's approval. And Provenge did not get approved. And meanwhile in the US alone some 30,000 advanced stage prostate cancer men die every year, and about 1/2 of them do not consider chemotherapy to be a viable option because of its terrible side effects. Provenge has virtually no side effects. Let's face it. The chemo people and the hedge funds that bet hugely against Provenge won!

A lawsuit has been filed by Caretolive against the FDA and details can be found here: http://caretolive.com/LawsuitLinks.html

Kerry M. Donahue, the trial attorney for defendants, representing some prostate cancer patients, etc. is an angel.

The following story is the best account of this horrible misery that the a bunch of suckers orchestrated against life, against goodness, against ethics, and all that stands for decency, in favor of money. It is a sad account of how money has become the new God in the minds of some people.


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Reprinted with permission

http://www.opednews.com/articles/genera_evelyn_p_071009_fda_industry_insider.htm



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13 DEC 2007

Congressmen Mike Michaud, Dan Burton, Tim Ryan called on the House Energy and Commerce Committee to conduct a hearing to examine the conflict of interests governing the Food and Drug Administration (FDA) and its recent decision on failing to approve licensure of Provenge.

“Many ethical questions remain about the two panelists who voted no on approving this drug,” Michaud said.  “I believe that the FDA should not be appointing scientists leading the testing of a rival drug for another firm onto an advisory committee evaluating Provenge. Congress needs to get to the bottom of this.  I believe a full disclosure is necessary in order to restore confidence in the FDA.”

“We need to ensure that the FDA gets life-saving drugs to the market as quickly and as safely as possible,” Michaud stated.  “Our priority is to ensure the prompt and efficient approval of therapies such as Provenge that could potentially benefit millions of Americans with cancer.”



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interesting post on an alleged panic meeting to help shoot down the approval of a safe effective agent for dying men :

http://www.investorvillage.com/smbd.asp?mb=971&mn=170174&pt=msg&mid=3682238


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Jonathan Aschoff of Brean Murray is a class act. He is a security analyst who impersonated doctor in order to get confidential information. I came across this web page which is quite funny (and sad). He was fined by the NASD.

http://aschoff.blogspot.com/2007/04/jonathan-aschoff-from-brean-murray-hes.html



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Very  interesting discussion about Drs. Maha Hussain and Howard Scher, conflict of interest, chemotherapy vs. immunotherapy, etc.: 

http://caretolive.com/CTLfinalvsPazScher.pdf

Here is the html version: CTLfinalversion17mocontradismiss.html


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This is one heck of a post. I do not know if all the allegations are true but IF they are true, they unfold a core of evil at the FDA and shows how power play can mean lost lives.

Pazdurs fun house.....or Pazdurs house of horrors for the patients - Pazdurs playhouse.....or Pazdurs house of horrors for patients

http://www.investorvillage.com/smbd.asp?mb=971&mn=163536&pt=msg&mid=3426907



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This is an extremely interesting reading:

PLAINTIFF’S SUPPLEMENTAL MEMORANDUM IN SUPPORT OF MEMORANDUM IN OPPOSITION DEFENDANT’S MOTION TO DISMISS AND AS SUPPLEMENT TO MOTION FOR INJUNCTIVE RELIEF

9nov_provenge.pdf


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October 9, 2007 at 02:33:16

FDA Industry Insiders Derail Approval of New Cancer Treatments

by Evelyn Pringle  

http://www.opednews.com



FDA Industry Insiders Derail Approval of New Cancer Treatments

George W Bush's FDA, stacked with insiders from the industry that literally carried him to Washington, has stooped to a new low to protect the obscene profits of the multi-billion dollar cancer industry by blocking the approval of a new class of immunotherapies that can extend the lives of dying cancer patients with minimal side effects.
 
In the May 14, 2007, Wall Street Journal, a former medical officer in the FDA Office of Oncology Products, Dr Mark Thornton, denounced the FDA's decisions, and stated, "May 9, 2007, should be cited in the annals of cancer immunotherapy as Black Wednesday."

"Within an eight-hour period that day," he wrote, "the FDA succeeded in killing not one but two safe, promising therapies designed and developed to act by stimulating a patient's immune system against cancer."

Experts say, the new immunotherapies hold promise for many forms of cancer. "FDA's hubris will affect the lives and possibly the life spans of cancer patients from nearly every demographic, from elderly men with prostate cancer to young children with the rarest of bone cancers," according to Dr Thornton.

With the approval of the new therapies, the profits, along with the horrendous side effects of the only treatments now available, could become a thing of the past. "One day current treatment approaches such as surgery, radiation and chemotherapy, which often kill most but not all of a cancer, could be made obsolete by a potent immune response that eradicates the cancer cells and provides subsequent protection against return and relapse," Dr Thornton wrote.

As such, the new therapies pose a grave threat to the cancer industry as a whole, and the lost profits would not be limited to the sale of products. The pharmaceutical giants have spent a small fortune to gain control of every segment of the industry, from researchers to government regulators, and every year, billions of dollars flow through a nationwide network of research institutions and treatment providers under the guise of finding a cure for cancer.

However, the profits up for grabs have become so enormous that critics say the goal of industry-controlled research is no longer focused on finding a cure for cancer to save lives. Instead, the focus is on thwarting the development and approval of new therapies in order to protect the profits of the treatments already on the market.

The FDA's refusal to approve Provenge, a new immunotherapy vaccine manufactured by the Dendreon Corporation, has caused major outrage in the cancer community. Provenge supporters have sent thousands upon thousands of letters and other correspondence to the FDA, members of Congress, the Department of Justice and others.

In addition, the Ohio-based non-profit corporation, CareToLive, has filed a lawsuit on behalf of terminal cancer patients seeking a declaratory judgment that the FDA acted "arbitrarily" and "capriciously" by denying patients access to Provenge, in violation of their constitutional right to live.

Dendreon sought approval to treat late-stage androgen-independent prostate cancer (AIPC) patients who have no other options. A study presented to an FDA Advisory Committee at a March 29, 2007, meeting showed that, after 36 months, 34% of the men who received Provenge in a clinical trial were still alive, compared to only 11% of those who received a placebo.

Provenge is designed to stimulate the patient's own immune system to specifically attack only cancer cells, unlike chemo drugs that attack any fast-growing line of cells.
Patients who qualify for Provenge have already had their prostates removed or have undergone radiation and hormone therapy. Eligible patients receive a one-time round of treatment consisting of 3 visits to a urologist's or oncologist's office to give blood, and 3 visits for the blood enhanced with Provenge to be infused back into the body.

On September 10, 2007, CareToLive filed a motion asking the court to issue an order enjoining the FDA from denying the marketing and distribution of Provenge. The plaintiffs charge that within six months, another 15,000 patients will have died waiting for justice.

The memorandum filed with the motion points out that the only available treatment approved for terminal AIPC in the last 42 years is a chemo drug, Taxotere. "The effectiveness of Taxotere," it states, "is so superficial, and the side effects so severe, that most men decline the treatment, as the risks far outweigh the benefits."

According to the filing, between 300 and 600 patients per year die from the Taxotere treatment itself. "This is truly amazing," the memo states, "considering the cost of the treatment and the cost of hospitalization and that the average benefit is an increase in survival of only 2 ˝ months."

In contrast, the Provenge safety profile is so good that nobody has died from it and less than one in four patients experience side effects consisting of mild flu-like symptoms lasting one or two days, the memo notes.

The defendants named in the lawsuit include Mike Leavitt, Secretary of the US Department of Health and Human Services; FDA Commissioner Andrew von Eschenbach; Dr Richard Pazdur, head of the FDA's Office of Oncologic Drug Division, and Dr Howard Scher, chosen by Dr Pazdur to serve on the advisory panel set up to review the approval of Provenge.

CareToLive is represented pro bono by Attorney Kerry Donahue, of the Dublin, Ohio law firm Bellinger & Donahue, while the FDA officials are represented by a legal team of 11 government attorneys, at last count, funded by tax dollars.
 
The plaintiffs allege that the defendants engaged in a conspiracy to prevent the approval of Provenge and that Dr Pazdur, "purposely located two conflicted oncologists who he was sure for a variety of reasons would be anti-Provenge and he instructed them to try to derail the approval of Provenge."

The plaintiffs charge that, by choosing Dr Scher, and also Dr Maha Hussain, to serve on the advisory panel, Dr Pazdur "likely found two of the most conflicted oncologists in the country to sit in judgment of Provenge, and who would both assuredly continue his plot to lobby others at the FDA to vote for non-approval."

At the behest of Dr Pazdur, and for their own future political and monetary gain, the plaintiffs claim, "these two oncologists did everything they could think of to obstruct and impede the approval of Provenge."

The waiver of conflicts of interest granted by the FDA to Dr Hussain, which allowed her sit on the panel, reveals that she is the lead investigator on a research contract awarded by a company that competes with Dendreon, and her husband owns stock in three competing companies valued at between $15,000 and $300,000.

The lawsuit alleges that, as part of the conspiracy, on May 9, 2007, the FDA denied terminally-ill patients access to Provenge, even though the FDA Advisory Committee recommended approval, found the vaccine safe by a 17-0 vote and found there was "substantial evidence" of efficacy with Provenge by a 13-4 vote.
In an attempt to derail an approval recommendation by the panel, the plaintiffs claim that, prior to the vote on efficacy, Dr Pazdur and "his co-conspirators changed the statutory question regarding efficacy from 'substantial evidence' to 'absolute certainty' of efficacy, in an effort to obtain a 'no' vote on Provenge."

However, during the voting, this manipulation was discovered and promptly corrected by the FDA's Dr Celia Witten and Dr Jesse Goodman, and by an overwhelming majority, the panel voted "yes" to the revised efficacy question.

"It is unprecedented for the FDA to overturn the Advisory Committee on such a positive vote when men are out of options, delaying approval and asking for more trials," according to CareToLive spokesman Mike Kearny in an August 2, 2007, press release.

"Men are dying now," he states. "They do not have years to wait."

In the case of Provenge's approval, the profits at stake could not be higher. Prostate cancer is the most common non-skin cancer in the US and the third most common cancer worldwide. More than one million men in the US have prostate cancer, with an estimated 232,000 new cases diagnosed each year and more than 30,000 men face death from the disease each year.

As an initial treatment, when diagnosed with prostate cancer, most men have their prostate removed, or undergo radiation, which can lead to various degrees of incontinence and impotence. After the initial treatments fails, hormone therapy is given to block the production of androgens such as testosterone, needed for cancer cells to grow, and some men undergo testicle removal in an attempt to stop the androgens from spreading the cancer.

With AIPC patients, prostate cancer has usually gone into remission and then returned, spreading to other parts of the body including the bones, lymph nodes, bladder, rectum, liver and lungs. All men who do not die of other causes progress to the final stage where the cells no longer respond to hormone therapy. Provenge is intended for use by patients who have already failed other types of therapy.

Because Taxotere is the only approved drug, Sanofi would have suffered the greatest immediate loss had Provenge been approved. According to firm's 2006 Annual Report, Taxotere was the company's 4th best-selling product in 2006, and the US is listed as the number one country contributing to sales.

As far as profits per dose, in the February 7, 2007, article, "What Does It Cost to Have Cancer?", a patient who received the chemo drug for breast cancer in 2006 reported that "each infusion of Taxotere cost over $16,000."

She also stated: "That's just for the drug, not administration or anything."

According to the lawsuit, defendant Dr Scher, Chief Genitourinary Oncology Service, Memorial Sloan-Kettering Cancer Center, is a scientific advisor and lead trial investigator for a competitor of Dendreon called Novacea. Under faculty disclosures at the University of Michigan, Dr Hussain is listed as an advisory board member of Novacea, and she receives research funding from Sanofi.

Dr Scher also has an interest in ProQuest Investments, which stood to reap windfall profits if Provenge was not approved. ProQuest is a venture capital fund established in 1998, in large part by Michael Milken, who was given the nickname "Junk Bond King," after being indicted on nearly 100 counts of insider trading and sentenced to 10 years in prison, in addition to being barred from the securities industry for life.

The ProQuest fund was established with a specific focus on prostate cancer, and SEC filings show that ProQuest and its principals are major shareholders of Novacea.

Citing documents from ProQuest, the plaintiffs allege that Dr Scher is a "ProQuest Executive" and "member of the Board of Directors", ProQuest reaps millions of dollars investing in prostate cancer companies based on advice from doctors such as Dr Scher, and ProQuest own stock in direct competitors including Novacea.

Dr Scher receives compensation from ProQuest as a scientific advisor recommending investments and for conducting clinical trials that result from the investments. He also holds an ownership interest in ProQuest.

The lawsuit also alleges that Dr Scher receives research support from the Prostate Cancer Foundation, as well as financial benefits, as one of a consortium of members who reviews new research on cancer drugs to determine which grants should be awarded by the Foundation.

The PCF, also founded by Mr Milken, is one of the largest sources of funding for the National Cancer Institute and government research programs. A following of the tangled web involved in the PCF reveals that Dr Jonathan Simons, President of the Foundation, Dr Stuart Holden, Medical Director, and Dr Howard Soule, an Executive Vice President of the Foundation, are all scientific advisors to ProQuest.

Another research arm found to be infested with several of the same insiders is the Prostrate Cancer Research Program, within the Department of Defense, which since 1997 has been appropriated a total of $730 million by Congress. According to a PCRP report, "Today, the PCRP is the second leading source of extramural prostate cancer research funding in the United States."

The PCRP funds a Clinical Consortium Award to support the creation of a major multi-institutional clinical trial resource, "to speed development of novel therapeutics that will ultimately decrease the impact of the disease."

Here, too, Dr Scher is listed as the leader of the consortium, and the list of participating clinical sites and lead investigators includes none other than Dr Hussain. Dr Simons is listed as developing new clinical therapeutics for late-stage prostate cancer, but a review of upcoming research listed in the report shows immunotherapies are not in the cards.

These consortium members are invaluable to the industry and investors due to their unique access to insider information about clinical trials and influence over the FDA approval process. Evidence of this claim came on May 30, 2007, less than 3 weeks after approval for Provenge was denied, when Novacea announced an agreement with Schering-Plough worth over $450 million, in which Schering agreed to jointly fund and develop Asentar, a competing prostate cancer drug, for which Dr Scher happens to be the lead investigator.

"The partnership leverages Novacea's existing capabilities with Schering-Plough's experienced development, regulatory and commercial teams and will provide Novacea with an opportunity to support the commercialization of Asentar in the United States," John Walker, company chairman and interim CEO, stated in a May 30, 2007 press release.

A May 2000 ProQuest document provides insight about the investment firm's interest in Asentar's success and states: "ProQuest Investments is a $100 million oncology-focused investment fund, partnered by Jeremy Goldberg and Jay Moorin."

Mr Moorin owned 1,910,988 shares of Novacea stock at the time of a May 15, 2006, SEC filing, and the ProQuest document mentions an investment from Domain Associates, "whose general partner, Jim Blair, has also worked with the fund to plot its strategy."

As it turns out, Mr Blair and Mr Moorin were both members of Novacea's board of directors when the Schering deal was set up. However, apparently their services are no longer needed, because on August 30, 2007, Novacea announced the resignation of James Blair and Jay Moorin, effective September 4, 2007, and September 19, 2007, respectively.

All that said, it does not take a financial genius to figure out that this whole deal could have gone up in smoke had Provenge been approved, because there would have been a drastic drop in the enrollment of late-stage cancer patients in clinical trials as soon as they learned that there was a new vaccine that could not only increase their survival rate but allow them to live out their final days without the agonizing side effects of chemotherapy.

Provenge's approval also would have caused many patients currently participating in trials to drop out. Novacea's 2006 Annual Report filed on April 2, 2007, less than 2 months before the Shering announcement, warned that the "clinical development and regulatory approval processes inherently contain significant risks and uncertainties."

The report shows Novacea was going broke trying to keep the Asentar trials running, with research and development expenses associated with the drug of $12.9 million for the year ended December 31, 2006, up from $7.3 million for the year ended December 31, 2005.

The $5.6 million increase was due primarily to the Phase 3 Asentar trial, and the filing warns that Novacea could experience many delays in getting its product to market due to problems in trials including, "patient enrollment may be slower than expected at trial sites due to factors including the limited number of, and substantial competition for, suitable patients with the particular types of cancer required for enrollment in our clinical trials".

It also notes that there "is a limited number of, and substantial competition for, suitable sites to conduct our clinical trials; clinical trial sites may terminate our clinical trials"; "patients and medical investigators may be unwilling or unable to follow our clinical trial protocols;" and "patients may fail to complete our clinical trials once enrolled."

In addition, another ongoing trial is evaluating Asentar as part of a combination therapy for AIPC patients with Sanofi's Taxotere. If safety or efficacy issues arise with Taxotere, the annual report warns, Novacea could experience significant regulatory delays, and the clinical trial may need to be terminated or redesigned.

Even if Asentar were to receive FDA approval, Novacea would continue to be subject to the risks that could arise with Taxotere or that Taxotere may be replaced as the standard of care for AIPC. "This could result in Asentar ™ being removed from the market or being less commercially successful," the report states.

Ironically, in one of 3 derogatory letters sent to the FDA urging the non-approval of Provenge leaked to the media following the failed efforts to rig the advisory panel vote, Dr Scher discussed the same fatal effects that the approval could have on the research industry. "An approval recommendation has far reaching implications beyond making the product available that the data simply do not support or justify," he wrote.

Approval would provide the Agency's endorsement of Provenge as a "standard of care" for men with AICP, he said, and by extension, elevate Provenge "to a position of being the new 'control' arm for future randomized phase 3 trials that are being designed for the regulatory approval of any new experimental agent or approach."

In other words, all the billions of dollars invested in the clinical trials now underway, or set to begin, conducted in hopes of gaining FDA approval for a new ACIP treatment, could go right down the drain if Provenge is approved as the first-line treatment for this patient population.

Dr Scher is probably more aware of this fact than anybody. On February 26, 2007, MedPage Today reported that in a satellite symposium titled, "Improving Upon Current Standards: The Integration of Novel Therapies in the Treatment of Androgen-Independent Prostate Cancer," sponsored by Novacea, Dr Scher said Taxotere-based combination therapy is being investigated in a dozen clinical trials for ACIP patients, and he reported receiving grants and research support from both Novacea and Sanofi.



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 http://www.investorvillage.com/smbd.asp?mb=971&mn=161294&pt=msg&mid=3305795

CTL Lawsuit Reflections

After reading the better part of Kerry's unbelievable legal work I am left with the following basic questions that I hope the Judge will carefully consider prior to making his decision in the CTL case.

How often is the head of CDER present at a CBER AC meeting?
How often is the Substantial Efficacy question miss-worded at AC Meetings?
How often are such conflicted AC panelists permitted to attend AC's & vote?
How often are letters leaked post AC to influence an FDA decision?
How often has the FDA overruled a positive AC vote for a late stage disease?
How often does the SI in a stock increase markedly after considering the above?
How often has the media been so negative after considering the above?

Obviously, there are many other questions that can be added to the list (i.e. Von E's speeches for one). My point and opinion is that the more oddities/irregularities that are introduced to the list the more clear it becomes how unbelievably jaded and corrupt the Provenge travesty was. Of course none of this information is new to anyone here; I just pray that the Judge lets his eyes be opened as wide as ours have.

One very big thank you to Kerry and all the other incredibly selfless people here that have given so much! IMHO you will all take up a bigger chapter in history than is readily apparent today.

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A great letter to Hon. Senator Charles (Chuck) Grassley regarding Howard Scher's letter:

http://www.investorvillage.com/smbd.asp?mb=971&mn=161222&pt=msg&mid=3300906


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On Michael Milken:

http://www1.investorvillage.com/smbd.asp?mb=971&mn=172822&pt=msg&mid=3765225

Michael Milken and the Prostate Cancer Foundation’s Foul Balls:

http://caretolive.com/2007-11-18/michael-milken-and-the-prostate-cancer-foundations-foul-balls/

Picture of Michael Milken and Andy Von Eschenbach and Picture of Mike Milken & Howard Scher:

http://www.prostatecancerfoundation.org/site/c.itIWK2OSG/b.734793/k.3E28/Photos_from_the_2005_Home_Run_Challenge_to_support_the_Prostate_Cancer_Foundation.htm

 


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Good article in Nature about the crooked elements working to delay a life extending safe agent from reaching terminal patients:
http://www.nature.com/nbt/journal/v26/n1/full/nbt0108-1.html

Quoting from the article:
"At least one of the Office of Cellular, Tissue and Gene Therapies Advisory Committee members who voted against Provenge and then wrote to FDA to criticize the approval recommendation—Howard Scher of Memorial Sloan-Kettering Cancer Center—failed to disclose important competing financial interests. Scher is a scientific advisory board member of venture capital firm ProQuest, which owns an 8.3% stake in Novacea, a company that was developing a competing prostate cancer drug, Asentar. Scher also happens to be the lead investigator in Asentar trials."

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Here's an interesting post about Howard Scher, Maha Hussain, etc.

http://www.investorvillage.com/smbd.asp?mb=971&mn=177793&pt=msg&mid=3961558


http://www.investorvillage.com/smbd.asp?mb=971&mn=181520&pt=msg&mid=4103477
5 reasons the E&C should conduct the investigation




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A post by KDDublin (reprinted with permission): http://www.investorvillage.com/smbd.asp?mb=971&mn=199222&pt=msg&mid=4876203 Hey, hey FDA, ain’t no way were ever going to go away.

Trust me when I tell you, that not only does the FDA monitor this site, but so does their counsel.

Here is an open letter:

Listen up FDA. We are never, ever, going to go away!!!

Tomorrow is merely one day. ONE DAY!! It is merely the first day in the rest of your lives!!

While I am confident that Andy’s days are numbered for his complete incompetence in running the FDA, you other career bureaucrats, Pazdur, Woodcock and Goodman, need to know that we will be here for you every step of the rest of your pathetic careers. You get to look forward to our presence for many years to come!

This grass roots movement has just begun. We are just now starting the fight. We grow stronger by the week. The CareToLive web site has thousands of new and unique visitors to its site every week. The word is spreading fast now and you can’t stop it anymore. Once the world knows of your misdeeds you will no longer be able to hide amongst your fellow corrupt brethren.

While you and your big pharma buddies laugh and giggle and plot against little biotech companies like Dendreon, so you can maintain your big bucks status quo, and seek to climb you career ladders and grab what power you think you can, those who are trying hard to make Cancer a treatable condition rather than a deadly disease, will expose those Andy bullshit “bridge not a barrier” speeches that he makes in the name of politics for the benefits of Congress, and the real advocates fighting on the front lines of the war on cancer will continue to fight the number one barrier to winning that war,…...THE CORRUPT FDA!!!!!!!!!

Tomorrow it is Coast to Coast demonstrations and that will be a nice start. But you need to understand it is merely A START! Next we are coming to MLB ballparks throughout the country, and then to back to Rockville, and this time there won’t be two hundred people in Rockville, there will be two thousand!

Men are dying while Woodcock, Pazdur and the FDA are wined and dined by big pharma. Men are dying while Scher lines his pockets at the expense of the patients he is sworn to protect. Men are dying while your friends profit. NO MORE!!!!!

Stand up 2 cancer. You bet we will. Those at CareToLive know where the front lines are and we will keep reinforcing those lines until we defeat cancer and the enemy that stands in the way of the patient’s ability to win that war, which those with knowledge know to be YOU!!!!!

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Words of Howard Scher at the panel meeting. Makes you really wonder if this jackass is in the pocket of Big Pharma and/or hedge funds who had a lot to lose on Provenge's approval? Only ones who lost were dying cancer patients who were denied a life extending safe biologic agent.

---

Does anyone remember Dr. Scher's answer to the 2nd question? Here is is...
I wonder what he meant? About what was he concerned? Hmmmmmmmm...what could possibly be on his mind?  Asentar?  Naw!

DR. MULÉ: Dr. Scher?

2 DR. SCHER: I think we are really

3 poised at the beginning of what will be

4 hopefully an outstanding era of

5 immunotherapy. I think there is sufficient

6 evidence demonstrated which justifies the

7 definitive study, and obviously there are

8 investors in that who concurred, but I think

9 it does not meet the -- as the question was

10 phrased, to establish the efficacy. I think

11 this is still an open question.

12 DR. MULÉ: So I take it you're

13 saying yes with these provisos?

14 DR. SCHER: We have two

15 questions. I would say yes to one, no to

16 the second. The first question as posed, as

17 established, I say no.

18 DR. MULÉ: No, it's substantial

19 evidence.

20 DR. SCHER: I will say no.

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