bluuebunny/crossref_metadata_2025_split huggingface dataset:
RADT-06. SPARING OF MOTOR STRUCTURES IN ADJUVANT RADIATION THERAPY AFTER RESECTION OF BRAIN METASTASES: APPLICATION OF NTMS-DERIVED DTI-BASED MOTOR FIBER TRACKING IN ADJUVANT STEREOTACTIC RT TREATMENT PLANNING
Authors: Diehl Christian , Rosenkranz Enrike , Mißlbeck Martin , Schwendner Maximilian , Sollmann Nico , Eitz Kerstin , Bernhardt Denise , Ille Sebastian , Meyer Bernhard , Combs Stephanie , Krieg Sandro 
Published: November 2022

Abstract

BACKGROUND
Resection of brain metastases (BM) close to the motor cortex and the corticospinal tract (CST) bears a significant risk for treatment-related morbidity. Navigated transcranial mapping (nTMS) combined with diffusion-tensor-imaging (DTI) based fiber tracking (DTI-FTTMS) is a valuable tool to guide the neurosurgeon along the CST to preserve motor function. This study aims to proof the practicability of DTI-FTTMS in local adjuvant stereotactic RT planning in the management of BM. Method: Pre-surgical generated DTI-FTTMS-based CST reconstructions of 24 patients with 25 resected BM were incorporated into the RT planning system and elastic fused with planning imaging. The CST was delineated as the planning risk volume (PRV-FTTMS). Fractionated stereotactic intensity-modulated RT (IMRT) plans (7 x 5 Gy) were retrospectively calculated and then optimized to preserve PRV-FTTMS. Areas covered by the planning target volume (PTV) were not spared (overlap).

RESULTS
In regular plans mean dose (Dmean) of complete PRV-FTTMS was 5.4 ± 2.5 Gy. Regarding PRV-FTTMS portions within the 8.75 Gy (25% of prescription dose) isodose level Dmean was 18.2 ± 4.3 Gy and after plan optimization 13.1 ± 3.8Gy (-28.0%, p &lt; 0.001). Within the 17.5 Gy (50%) isodose line PRV-FTTMS Dmean was reduced by 31.7% from 24.3 ± 3 Gy to 16.6 ± 4.8 Gy (p&lt; 0.001). There was no decline of the effective treatment dose, PTV Dmean in regular plans was 36.9 ± 0.7 Gy vs. 37.7 ± 1.4Gy (p=0.013) after adaption. PTV coverage (V35Gy(%)*100) did not change with plan optimization: 0.99 vs. 0.99 (p=0.43). Dose constraints of organs at risk were all met both in regular and optimized plans.

CONCLUSION
DTI-FTTMS based motor tracts could be implemented in the adjuvant stereotactic RT planning of cavities after resection of BM. A significant dose reduction of motor structures within critical dose levels seems possible without reducing PTV treatment dose. However, the functional benefit needs to be investigated prospectively within clinical trials.
RADT-12. PRE- AND POST-OPERATIVE RADIATION TREATMENT PLANNING FOR PATIENTS RECEIVING STEREOTACTIC RADIOSURGERY FOR BRAIN METASTASES: A VOLUMETRIC ANALYSIS
Authors: Ho Cindy , Perlow Haley , Ritter Alex , Gokun Yevgeniya , Matsui Jennifer , Wang Joshua , Damante Mark , Blakaj Dukagjin , Beyer Sasha , Thomas Evan , Lonser Russell , Hardesty Douglas , Raval Raju , Palmer Joshua , Elder James 
Published: November 2022

Abstract

BACKGROUND
Pre-operative stereotactic radiosurgery (SRS) has emerged as a recent treatment option to treat large or symptomatic brain metastases. Compared to post-operative SRS, pre-operative treatment may reduce rates of radiation necrosis (RN) and meningeal disease through treating a smaller treatment volume and by preventing post-operative tumor seeding. We hypothesize that pre-operative radiation volumes will be smaller than post-operative volumes, which in turn may lead to a decreased treatment morbidity.

METHODS
A retrospective analysis was conducted and patients who had surgical resection and post-operative SRS or fractionated stereotactic radiosurgery (FSRT) for a posterior fossa brain metastasis were eligible for inclusion. Both pre-operative and post-operative MRIs were required to allow for accurate radiation target delineation. A pre-operative tumor volume was added for each patient, and the post-operative clinical treatment volume (CTV) used for radiation treatment was included. Pre-operative tumor and post-operative cavity volumes were compared using Wilcoxon signed rank test.

RESULTS
28 patients who received post-operative SRS or FSRT from 1/1/2016-12/31/2020 were included in this analysis. The mean pre-operative tumor volume was 14.9 ccs, and the mean post-operative CTV was 21.0 ccs (p &lt; 0.01). 75% of patients had a smaller initial tumor size compared to the post-operative CTV used for radiation treatment planning. For patients with at least 4 follow up MRIs (n = 8), the size of the post-operative cavity progressively decreased with a mean initial cavity volume of 18.9 ccs and mean follow up volumes of 8.1, 7.1, 6.9, and 6.2 ccs.

CONCLUSIONS
In this study evaluating patients who received post-operative SRS, the pre-operative tumor volume was lower than the post-operative CTV for most patients. Previous studies including PROPS-BM have shown how pre-operative treatment may reduce the risk of RN because smaller radiation volumes are used. Pre-operative radiosurgery for patients with brain metastases requires prospective validation.
RADT-13. CLINICAL OUTCOMES COMPARING RADIOSURGERY TECHNIQUES FOR MANAGING LARGE BRAIN METASTASES
Authors: Kutuk Tugce , Kotecha Rupesh , Tolakanahalli Ranjini , Appel Haley , Hall Matthew , Wieczorek D Jay , Lee Yongsook , McDermott Michael , Ahluwalia Manmeet , Gutierrez Alonso , Mehta Minesh , Tom Martin 
Published: November 2022

Abstract

INTRODUCTION
Large brain metastases (BM) are associated with poor local control with single-fraction radiosurgery (SRS) alone. We sought to compare outcomes with various alternative management strategies to assess disease control rates.

METHODS
Consecutive patients diagnosed with BM ≥ 2 cm in maximum diameter between 3/2019-2/2021 and treated at a single tertiary institution were included. Primary endpoints included freedom-from-local-failure (FFLF) calculated on a per-lesion basis from the date of initial intervention to local failure, and overall survival (OS). Kaplan-Meier analysis and the log-rank test were used.

RESULTS
86 patients with 102 large BM met inclusion criteria. The median age was 66 years (range: 31-98), median KPS was 90 (50-100), and 57.8% were female. The most common primary tumor was lung in 40 (39.2%) lesions. The median tumor volume was 9.7 cm3 (2.1-35.5 cm3) and the median maximum tumor diameter was 3.3 cm (2.9-5.6 cm). 37 (36.3%) lesions were treated with staged-SRS, 31 (30.4%) with resection and postoperative-SRS, 21 (20.6%) with preoperative-SRS and resection, and 13 (12.7%) with fractionated-SRS (FSRS). Lesions treated with preoperative-SRS or postoperative-SRS were associated with higher rates of no- or stable-extracranial disease, and larger tumor volumes (preoperative-SRS: median 14.5 cm3 [4.2-33.1]; postoperative-SRS: 18.0 cm3 [2.5-35.5]; FSRS: 5.9 cm3 [2.1-24.6]; staged-SRS: 6.5 cm3 [2.2-27.8]).With a median follow-up of 15.6 months, 12 (11.8%) local failures and 42 (41.2%) deaths occurred. 1-year FFLF and OS for entire cohort were 85.6% (95% CI: 77.9-93.3%) and 64.4% (95% CI: 54.7-74.1%), respectively. The 1-year FFLF (p=0.542)/OS (p=0.043) rates were 94.1%/100% for preoperative-SRS, 84.0%/43.4% for staged-SRS, 81.8%/74.1% for FSRS, and 81.5%/63.4% for postoperative-SRS, respectively.

CONCLUSION
Although limited by patient numbers, selection bias, and high attrition rate, preoperative-SRS had the numerically most favorable outcomes, supporting this approach for large BM. Prospective evaluation is warranted to determine the optimal management strategy.
RADT-20. REPORT OF THE RESPECT-GBM™ PHASE I/IIA DOSE ESCALATION TRIAL OF RHENIUM-186 NANOLIPOSOME (186RNL) IN RECURRENT GLIOMA VIA CONVECTION ENHANCED DELIVERY (CED) & PLANNED PHASE IIB TRIAL
Authors: Brenner Andrew , Phillips William , Bao Ande , Hedrick Marc , LaFrance Norman , Michalek Joel , Patel Toral , Weinberg Jeffrey , Floyd John 
Published: November 2022

Abstract
A phase I/IIa dose escalation trial was initiated to determine the safety and recommended phase II dose (RP2D) of 186RNL in patients with recurrent glioma. Liposomal rhenium-186 (186RNL) is a source of high energy beta particles and gamma photons with attractive properties for brain CED.Patients with biopsy proven recurrent glioma had computerized treatment planning and placement of up to 4 intracranial catheter(s). Each patient received a single administration of 186RNL by CED. Whole body planar and SPECT/CT imaging from days 1-8 following treatment was performed. Patients were followed for safety, sufficiency of delivery and overall survival. Twenty-one patients across 6 dose escalation cohorts received 1.0-22.3mCi in a volume of 0.6-8.8mL. Mean tumor volume was 8.3mL, patients were heavily pretreated (mean 1.7 recurrences) with poor prognostic factors. There were no CED failures. Mean absorbed radiation dose to the tumor (MARDT) was 271Gy. No dose limiting toxicities were observed. Patients were stratified by MARDT. Those receiving &gt; 100Gy MARDT (n=12) had a median and mean overall survival of 129.9 (95% CI 35.1 to 169.3) and 99.5 ± 19 weeks respectively with 3 patients alive. Patients receiving ≤ 100Gy MARDT (n=9) had a median and mean overall survival of 22.4 (95% CI 6.6 to 45.4) and 24.7 ± 4.8 weeks respectively, none are alive. Kaplan Meier analysis of overall survival for patients receiving MARDT greater than 100Gy vs. those with ≤ 100Gy showed a statistically significant difference in overall survival (p&lt; 0.001).A single administration of 186RNL by CED in recurrent glioma patients is feasible, safe, and potentially effective in increasing overall survival when &gt; 100Gy radiation is delivered to the tumor. A RP2D of 22.3mCi in 8.8mL was selected for patients with tumor size of ≤ 15mL in the planned phase 2b trial. The PIIb trial design and comparative survival data will also be presented.
RADT-23. MODALITY-SPECIFIC CNS INJURY FOLLOWING PROTON VS PHOTON BEAM RADIOTHERAPY IN GLIOMA
Authors: Winter Sebastian , Gardner Melissa , Parsons Michael , Grassberger Clemens , Bussière Marc , Ehret Felix , Kaul David , Boehmerle Wolfgang , Endres Matthias , Shih Helen , Dietrich Jorg 
Published: November 2022

Abstract

BACKGROUND
CNS injury following brain-directed radiotherapy (RT) is common and may mimic disease progression. Dosimetric advantages of protons (PRT) over photons (XRT) minimize radiation to healthy brain, potentially limiting radiotoxic sequelae. We characterized CNS radiotoxicity i.e., radiation-induced leukoencephalopathy (RIL), brain tissue necrosis (TN), and cerebral microbleeds (CMB), during progression-free survival (PFS) periods in glioma patients irradiated with PRT or XRT.

METHODS
34 patients (19 male; mean age = 40.10y) with grade 2/3 gliomas treated by partial cranial RT were stratified by RT modality [XRT(n = 17) vs PRT(n = 17)] and matched on 11 criteria [age, sex, tumor type/location/laterality, mutational status (IDH; 1p19q deletion), concurrent/adjuvant chemotherapy, radiation dose/fractions] for retrospective analysis. Radiotoxicity was characterized longitudinally until 3 years post-RT via analysis of serial MRI T2/FLAIR- (RIL), T1+Contrast- (TN), and Susceptibility (CMB)-weighted sequences. RIL was rated using a novel scoring system with embedded Fazekas scale (intraclass correlation coefficient &gt; 0.9), at global (whole-brain) and hemispheric levels.

RESULTS
Analysis of delayed radiotoxicity at 3 years post-RT identified significant modality-specific differences. While both groups developed moderate-to-severe RIL [62% (XRT) and 72% (PRT)], XRT resulted in greater RIL injury dynamics (i.e., average % change between 1 and 3 years post-RT) in the contralesional hemisphere [F(1, 31) = 4.32, p &lt; .05]. Conversely, PRT was associated with higher TN incidence [6%(XRT) vs 18%(PRT) z = - 2.22, p &lt; 0.03, two-tailed]. Finally, while CMB incidence [76%(XRT) vs 71%(PRT)] and burden [mean #CMB: 4.3(XRT) vs 4.2(PRT)] were comparable, lesion-to-radiation field (RF)-correlation identified preferential CMB clustering at RF margins with PRT [X2(2, N =200)= 8.8, p &lt; .02].

CONCLUSIONS
CNS radiotoxicity is common and progressive in glioma patients. Injury patterns suggest radiation modality specificity as RIL, TN, and CMB exhibit unique spatiotemporal differences following XRT vs PRT, likely reflecting dosimetric and biological differences between protons and photons. The impact of such sequelae on cognition is subject of current investigation.
RADT-30. RADIATION INDUCED MENINGIOMA IN BACKGROUND OF CHILDHOOD CRANIAL IRRADIATION: A CASE SERIES
Authors: Gupta Sunnia , Swampillai Angela , Brazil Lucy , Al-Salihi Omar 
Published: November 2022

Abstract

BACKGROUND
Cranial irradiation as part of prophylactic (PCI) or radical treatment for childhood malignancies can be associated with late consequences such as radiotherapy induced meningioma.

METHODS
We are reporting 5 such patients treated at our institute.

RESULTS
Case 1: 24y female received PCI for Acute Lymphoblastic Leukemia at the age of 2, and developed right frontal meningioma which was resected and pathology confirmed grade 2 atypical meningioma. It was treated with radiotherapy 60Gy/30fr and 2 year follow up scans remain stable. Case 2: 31y male received PCI as a child, and developed parieto-occipital meningioma which was excised multiple times. Pathology revealed Grade 2 atypical meningioma and was treated with radiotherapy 60Gy/30fr. Follow up scans 3.5 yrs later remain stable.Case3: 37y male received PCI at the age of 3, and developed multiple site meningiomas which were excised. Pathology showed likely Grade 2 meningioma. The sphenoid wing lesion progressed 2 years later, was re-excised and treated recently with radiotherapy 60Gy/30fr. Case 4: 52y female treated with radiotherapy for retinoblastoma at the age of 6-8 wks, developed left sphenoid wing meningioma which was resected and pathology revealed malignant meningioma. Radiotherapy 60Gy/30fr was recently completed.Case 5: 24y female treated with radiotherapy for medulloblastoma at the age of 5, developed meningiomas at multiple sites. Over the span of 10 years the frontal and clinoid lesions increased in size, and were treated with SRS/SRT recently.

CONCLUSION
All patients had background of cranial radiation and developed meningioma with latency period ranging 19 to 52 years. It is not possible to make an inference on gender, site of meningioma or craniaI dose correlation because of small number of cases and lack of data on dose. Further research is needed on how to prevent secondary malignancies in such patients and on standard of care for secondary meningiomas.
RADT-32. ADJUVANT RADIOTHERAPY VERSUS SURVEILLANCE FOR GRADE 2 INTRACRANIAL MENINGIOMAS: A MULTICENTER STUDY
Authors: Byun Hwa Kyung , Chang Won Ick , Kim Il Han , Lee Joo Ho , Park Chul-Kee , Kim In Ah , Kim Chae-Yong , Suh Chang-Ok , Cho Jaeho , Kim Eui Hyun , Chang Jong Hee , Kang Seok-Gu , Moon Ju Hyung , Yoon Hong In , Wee Chan Woo 
Published: November 2022

Abstract

BACKGROUND
To compare the outcomes between adjuvant radiotherapy (ART) and surveillance in patients with grade 2 intracranial meningiomas (MNG2s) after surgical resection.Materials and

METHODS
This multicenter study included 518 patients with newly diagnosed MNG2 who underwent resection between 1998–2018. Patients receiving ART with conventional fractionation (n = 158) were compared with those undergoing surveillance (n = 360). Progression-free survival (PFS) and progression/recurrence (P/R) rates were evaluated. Propensity score matching was performed to adjust for covariables (n = 43 in each group).

RESULTS
The median follow-up was 64.9 months. The median ART dose was 60 Gy in 30 fractions. Patients receiving ART had larger tumors (median, 5.0 vs. 4.5 cm, P &lt; 0.001) and less frequent gross total resection (69.6% vs. 85.3%, P &lt; 0.001). In multivariable analysis, ART was associated with significantly improved PFS (HR, 0.34; 95% CI, 0.22–0.53; P&lt; 0.001) and P/R (HR, 0.29; 95% CI, 0.18–0.46; P&lt; 0.001). In the propensity score matched cohort, the 5-year PFS rates were 80.8% vs 57.7% (P = 0.020) in the ART and surveillance group, respectively. Even in patients receiving gross total resection, the 5-year PFS (85.0% vs. 64.7%; HR, 0.50; 95% CI, 0.27–0.91; P = 0.023) and P/R rates (15.2% vs. 32.0%; HR, 0.50; 95% CI, 0.25–0.96; P = 0.038) were significantly improved by ART. Using recursive partitioning analysis in patients undergoing surveillance, we classified patients to low-, intermediate-, or high-risk of P/R based on surgical extent, tumor size, and Ki-67 index. The 5-year P/R rates in the low-, intermediate-, and high-risk groups were 18.6%, 37.9%, and 65.3%, respectively.

CONCLUSION
ART significantly improved PFS and P/R in MNG2s irrespective of surgical extent and should be recommended after both gross total and partial resection. A recursive partitioning analysis model for P/R may guide clinicians for decision making in resected MNG2s.
RADT-40. RADIATION-INDUCED CONTRAST ENHANCEMENT FOLLOWING PROTON RADIOTHERAPY FOR LOW-GRADE GLIOMA DEPENDS ON TUMOR CHARACTERISTICS AND IS RARER IN CHILDREN THAN ADULTS
Authors: Eichkorn Tanja , Bauer Julia , Deng Maximilian , Bahn Emanuel , Lischalk Jonathan , Eva Meixner , Elisabetta Sandrini , Regnery Sebastian , Held Thomas , Juliane Hoerner-Rieber , Alber Markus , Klaus Herfarth , Juergen Debus , Semi Harrabi , Laila Koenig 
Published: November 2022

Abstract
Proton beam radiotherapy (PRT) is used in the treatment of low-grade glioma (LGG) to mitigate long-term sequelae. Following PRT, increased rates of radiation-induced contrast enhancements (RICE) are suspected but poorly understood. We analyzed consecutive 227 patients (42 children and 185 adults) treated with PRT (54Gy RBE) for LGG from 2010 to 2020 and followed with serial clinical exams and magnetic resonance imaging for in median 5.6 years. Tumors were graded WHO 1 in a minority (n = 22, 12%) of adults, but a majority of children (n = 29, 69%). In contrast, tumors were graded WHO 2 in the majority (n = 160, 87%) of adults and a minority of children (n = 10, 24%). Five-year overall survival following PRT was 81% in adults and 91% in children. The risk of RICE was 5-fold more frequent in adults (25%) versus children (5%) (p = 0.0043). Also, within the adult cohort, RICE risk increases with age (p = 0,00128). In children and adults, RICE were symptomatic in 50% and 55% (n = 1 and 26) of cases with CTCAE grade 0 in 47% (n = 23), grade 1 in 25% (n = 12), 0% grade 2 (n = 0) and 29% grade 3 (n = 14), respectively. In adults, RICE risk was associated to WHO grading (8% in WHO grade 1 vs. 24% in WHO grade 2, p = 0.026), independent of age (p = 0.44) and irradiation dose (p = 0.005), but not independent of IDH mutational status. These data demonstrate effectiveness of PRT for LGG in both children and adults. The RICE risk is lower in children which are a main target group for PRT and differs with WHO grading.
CTIM-04. PHASE I STUDY OF IBRUTINIB WITH RADIATION AND TEMOZOLOMIDE IN PATIENTS WITH NEWLY DIAGNOSED GLIOBLASTOMA
Authors: Ahluwalia Manmeet , Patel Neha , Khosla Atulya , Rauf Yasmeen , Stevens Glen , Murphy Erin , Chao Samuel , Yu Jennifer , Suh John , Peereboom David 
Published: November 2022

Abstract

BACKGROUND
Glioblastoma is associated with dismal outcomes with a survival of 15-18 months. A major challenge in glioblastoma is the inability to effectively target glioma stem cells (GSCs) that have the capacity for self-renewal. GSCs are resistant to radiation and traditional chemotherapy agents. Ibrutinib is a first-in-class, potent, small-molecule tyrosine kinase inhibitor of Bruton’s Tyrosine Kinase (BTK) and Bone marrow X-linked (BMX). BMX nonreceptor tyrosine kinase activates STAT3 signaling to maintain self-renewal and tumorigenic potential of GSCs. Hence a combination of ibrutinib with radiation and temozolomide in Glioblastoma is a promising approach.

METHODS
Unmethylated MGMT GBM patients received ibrutinib daily with 60 Gy radiation over 6 weeks (Arm 1). MGMT methylated patients received Temozolomide at 75 mg/m2 in addition to Ibrutinib and radiation (Arm 2). Starting dose of Ibrutinib (level 1) was 420 mg daily, level 2 dose was 560 mg daily and dose level -1 was 280 mg. Patients received adjuvant Ibrutinib (Arm 1) and ibrutinib and temozolomide (Arm 2). The primary endpoint included the maximum tolerated dose (MTD) of Ibrutinib with radiation (Arm 1), and ibrutinib, radiation, and temozolomide (Arm 2). Progression-free survival and overall survival are secondary endpoints.

RESULTS
27 patients (15 males, 12 females), with a median age of 63 years (range, 34-77 years) were treated on two arms. Dose Limiting toxicity (DLT) in Arm 1 included grade 3 weakness, grade 4 transaminases, and grade 4 neutropenia. DLT in Arm 2 included grade 3 rash, grade 3 transaminases, grade 4 neutropenia, and thrombocytopenia. Ibrutinib was too toxic with radiation in Arm 1, MTD of 420 mg ibrutinib was confirmed in Arm 2.

CONCLUSION
MTD of Ibrutinib is 420 mg daily with Temozolomide and radiation. Efficacy outcomes (PFS and OS) will be presented.
CTIM-09. ENRICHED TCR/BCR VDJ REARRANGEMENTS CORRELATE WITH MRI AND SURVIVAL OUTCOMES IN PATIENTS WITH RECURRENT HIGH-GRADE GLIOMA TREATED WITH CAN-3110
Authors: Antonio Chiocca E , Nakashima Hiroshi , Mo Xiaokui , Solomon Isaac , Ling Alexander , Woods Jared , Bernstock Joshua , Villa Genaro , Piranlioglu Raziye , Landivar Ana Montalvo , Masud Nafisa , Triggs Daniel , Grant James , Wen Patrick Y , Lee Eudocia , Nayak Lakshmi , Chukwueke Ugonma , Batchelor Tracy , Krisky David , Aguilar-Cordova Estuardo , Aguilar Laura K , Fernandez Soledad , Matheny Christopher , Manzanera Andrea , Barone Francesca , Tak Paul Peter , Ligon Keith , Reardon David A 
Published: November 2022

Abstract

BACKGROUND
CAN-3110 (rQNestin34.5v2) is an HSV-1 oncolytic viral immunotherapy with one copy of the inflammatory ICP34.5 gene under transcriptional control of the Nestin glioma-specific promoter. We completed a phase 1 sequential dose-escalation trial of CAN-3110 in recurrent high-grade glioma (rHGG).

METHODS
CAN-3110 was injected intratumorally starting at 1x106 plaque forming units (pfu) and dose- escalated by half log up to 1x1010 pfu in biopsy confirmed rHGG. An expansion cohort of 12 patients was then accrued at 1x109 pfus. Blood and post-injection rHGG were collected.

RESULTS
41 rHGG patients were treated (42 separate interventions): median age 56 years (range 27-74); 21 females, 20 males; median baseline KPS 90 (range 70-100). CAN-3110 administration was well-tolerated with no dose limiting toxicities. Median overall survival (mOS) was 11.9 months. Histologic and molecular analyses showed significantly increased T cell infiltration in post treatment samples with elevated T cell and/or B cell receptor (TCR/BCR) transcripts which correlated with patient survival (HR 0.26 for patients with elevated TCR/BCR rearrangements as compared to patients with low). Volumetric analyses of MRI suggest a trend between reduction in the relative change in tumor growth, TCR/BCRs enrichment and survival in CAN-3110 treated patients.

CLINICAL IMPLICATIONS
Administration of CAN-3110 into rHGG was well tolerated. OS of CAN-3110 treated subjects compare favorably to historical controls. The association of increased TCR/BCR transcripts with survival suggests that CAN-3110 induces T cell responses against rHGG, supporting further clinical development of CAN-3110 viral immunotherapy.