Glioblastoma multiforme: immunotherapy followed by chemotherapy prolongs survival in patients

Immunotherapy combined with chemotherapy significantly slows tumor progression and prolongs survival in patients with glioblastoma multiforme, a highly aggressive and incurable form of brain tumor, according to a study published in the journal "Clinical Cancer Research ".

Although the exact mechanism of this therapeutic approach has not been clearly identified, the team of the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai Medical Center in Los Angeles, assumes that the tumor vaccine carries a first blow to cells tumor, which has the effect of increasing their susceptibility to anti-tumor drugs.

Before coming to such assumptions, the researchers followed 36 patients aged 32-78 years, who had prior to entering the study underwent surgical removal of their tumor, followed by radiotherapy. Divided into three groups, some patients then received only treatment for chemotherapy, other immunotherapy, others immunotherapy followed by chemotherapy.

Participants who received the vaccine, either alone or in combination with chemotherapy, were included in the study between 1998 and 2001 at the Institute of immunotherapy with dendritic cells, say the authors. This therapeutic approach is to introduce proteins taken from tumors in dendritic cells harvested from the patient's blood and then inject all as a vaccine to stimulate the immune system of patients, particularly T lymphocytes

Patients in the second and third groups received a total of three injections, two weeks apart. Some more received a fourth injection six weeks later. Then all were subjected to MRI every 2-3 months as part of their monitoring.

The median survival was 26 months for patients who were vaccinated and who received chemotherapy, against 18 months for those who received the immunotherapy treatment alone and 16 months for those who had not been treated by chemotherapy.

In addition, of the 12 patients who received dual therapy approach, five survived more than two years (41.7%), against only one of 12 patients under immunotherapy alone and 12 patients received chemotherapy alone, report the authors.

They conclude that "the acts synergistically with chemotherapy prior vaccination to generate a single effective treatment that slows the progression of glioblastoma multiforme and significantly extends patient survival compared to single therapies.

"If these results are reproducible, it would be extremely gratifying to see such an increase in survival in such a devastating disease," comments Keith L. Black, director of the institute and one of five researchers behind the study.

According to his colleague Christopher J. Wheeler, "the fact that the tumors treated with immunotherapy to be highly sensitive to chemotherapy successor dendritic cells suggests that the vaccine 'ready' machinery of cell death, or that alters the genetic or structural constitution of tumor cells . From there, it seems that this weakness is exploited by the administration of drugs that attack the DNA of the tumor. "

The authors are preparing now to conduct a Phase 3 clinical trial in collaboration with other institutions in order to confirm that the combination of immunotherapy and chemotherapy actually extends survival for patients with glioblastoma.