Immunotherapy for Glioblastoma Well Tolerated; Survival Gains Observed in Small Phase One Trial at Duke; Results Support Further Study in Larger Trials

A phase one study of 11 patients with glioblastoma who received injections of an investigational vaccine therapy and an approved chemotherapy showed the combination to be well tolerated, while also resulting in unexpectedly significant survival increases, researchers at the Duke Cancer Institute report. Patients treated with the study drug (dose-intensified temozolomide and vaccines) were continuously monitored for toxicity and adverse events. Study patients experienced known side effects with temozolomide, including nausea, lymphopenia, thrombocytopenia, and fatigue. There were no treatment-limiting adverse events and no adverse events related to the cellular portion of the vaccine. One patient developed a grade 3 vaccine-related allergic reaction to the GM-CSF component of the vaccine. The patient was able to continue vaccinations in which the GM-CSF was removed and had no subsequent adverse events. Although the trial was small and not designed to evaluate efficacy, 4 of the 11 study patients survived for more than five years following treatment with a combination of vaccine and the drug temozolomide, a first-line chemotherapy drug for glioblastoma. That outcome is uncommon for glioblastoma, a lethal brain cancer that has a median survival of nearly 15 months when treated with the current standard of care. "This is a small study, but it's one in a sequence of clinical trials we have conducted to explore the use of an immunotherapy that specifically targets a protein on glioblastoma tumors," said Duke's Kristen Batich (photo), M.D., Ph.D., lead author of a study published online on April 14, 2017 in the Clinical Cancer Research.
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