Abstract 2491: Treatment with tumor lysate-pulsed autologous dendritic cells prolongs survival in patients with recurrent glioblastoma multiforme
Authors: Bosch Marnix , Prins Robert , Liau Linda 
Published: August 2015

Background The survival rate in recurrent Glioblastoma multiforme (rGBM) patients has not meaningfully changed in the past several decades. We have treated two cohorts of rGBM patients, one consisting of patients with early progression, and one of patients with progression following several cycles of adjuvant temozomolide chemotherapy, with autologous dendritic cells pulsed with autologous tumor cell lysate (DCVax®-L). Such treatment is intended to activate the immune system against the tumor cells, so that the ensuing immune attack may delay progression and time to death.

Methods Disease progression in patients with GBM was determined through MRI. Progression needed to be determined by independent review on 2 consecutive scans for early progressor classification to avoid enrolling patients with pseudoprogression. Assessment of progression was done using modified RANO criteria.

Results Nineteen (19) patients diagnosed with GBM were determined to have recurrence immediately following radiation therapy with concomitant temozolomide chemotherapy. Median overall survival in this cohort from initial GBM diagnosis is 15.1 months (95% CI: 10.5-17.2), and the range is 8.1-&gt;31 months. A literature search revealed 6 publications with comparable populations of patients. The table below demonstrates that these patients typically have a life expectancy of 8-10 months.

Reference (n)PopulationMedian Survival (95% CI)DCVax-L (19)PD post RT+chemo, confirmed 2 months later15.1 months (10.5 - 17.2)Brandes et al. 2008 (18)PD at 4 weeks pos RT+chemo, confirmed after two more tmz cycles10.2 months (n.a.)Roldan et al. 2009 (10)PD at 4-6 weeks post RT+chemo, confirmed after ≥1 more tmz cycle(s)9.1 months (4.9 - 19.1)Kang et al. 2010 (10)PD at 2 consecutive scans post RT+chemo10.8 (n.a.)Sanghera et al. 2010 (29)PD at 2 consecutive scans within 8 weeks post RT+chemo8.3 months (n.a.)Gunjur et al. 2011 (27)PD at 2 consecutive scans within 3 months post RT+chemo, or clinical deterioration10.4 months (n.a.)Linhares et al. 2013 (13)PD at 2 consecutive scans within 3 months post RT+chemo9.0 months (3.7 - 14.3)

A second cohort of patients with rGBM consisted of 8 patients with recurrence following several adjuvant temozolomide treatment cycles. Median OS for these patients is 14.7 months from the time of surgery for first recurrence. The comparator for this cohort is derived from Friedman et al. (2009), who reported mOS of 8.7-9.3 months from the time of first recurrence for rGBM patients treated with Bevacizumab with or without Irinotecan.

Results and Conclusion These results suggest that treatment with DCVax-L can extend survival by 5 months or more in patients with rGBM.

Citation Format: Marnix Bosch, Robert Prins, Linda Liau. Treatment with tumor lysate-pulsed autologous dendritic cells prolongs survival in patients with recurrent glioblastoma multiforme. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 2491. doi:10.1158/1538-7445.AM2015-2491