Postoperative Adjuvant Dendritic Cell Based Immunotherapy in Patients with Relapsed Glioblastoma Multiforme

PFS for adult patients

PFS for adult patients

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Summary

The aim of this study is to investigate the therapeutic role of adjuvant vaccination with autologous mature dendritic cells (DC) loaded with tumour lysates derived from autologous, resected glioblastoma multiforme (GBM) at time of relapse. The results suggest that the DC-based immunotherapy with patients with glioblastoma is safe and can prompt long-term survival.

Patients characteristics

56 patients with relapsed high-grade glioma (Glioblastoma Multiforme WHO grade IV) ages 7- 77 years old with mean age of 46 years and with median KPS of 80. Patients undergone surgery and Radiation before the vaccination.

Methodology

• Peripheral blood mononuclear cells (PBMC) isolated using Lymphoprep.
• Subsequently, the monocyte fraction was enriched using plastic adherence
• The monocytes were cultured in six-well plates at a concentration of 107 cells per mL in short-term culture medium
• This medium consisted of RPMI-1640 supplemented with Glutamine, Penicillin, Streptomycin and autologous plasma
• The monocyte were differentiated into immature DCs by culture in the presence of recombinant human GM-CSF and recombinant human IL-4 for 7 days
• After 7 days, the immature DC were collected, maturation was induced with a cytokine mixture consisting of recombinant TNF-a and recombinant IL-1 and PGE2

Treatment

DC vaccines were injected Intradermally (ID) in the upper arms, were given week 1 and 3, 2-weekly interval and 4-weekly interval.

Results

• Only mild adverse events were observed in all the patients during the vaccination
• Grade II transient hematologic toxicity was seen in 2 patients
• Transient increase in focal neurologic signs in 6 patients. Headache in 9 patients, vomitus in 2 patients and flu-like symptoms in 3 patients
• Median progression-free survival (PFS) of all the patients was 3 months and median overall survival (OS) was 9.6 months• 1-year median OS was 37.4%, 2-year median OS was 14.8% and 3- year median OS was 11.1% • Age 35> had better median OS with 15.4 months and 7.5 months for patients older then 35 years old.

Conclusion

Adjuvant Dendritic cell-based Immunotherapy for patients with relapsed GBM is safe and can induce long-term survival.

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Scientific article publishing date: 5/15/2008

Immucura identifier BSC21_334EN

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